The Practice of Veterinary Surgery 



i 



The Practice 



of 



Veterinary Surgery 



The Basis of a Series of Lectures Delivered to 

the Seniors of the Grand Rapids 

Veterinary College 



By H. L. Schuh, D. V. M. 




1912 

Published by Grand Rapids Veterinary College 

Grand Rapids, Michigan 



N 






COPYRIGHT, I912 
BY H. L. SCHUH 



Press of De Vos & Son 
Coopersville, Mich. 



4 2--!>~' 






Table of Contents 



PAGES 

CHAPTER I — Diseases of The Eye 9-32 

Diseases of The Orbit — Retro-Bulbary Phlegmon 

Wounds of The Eyelids Blepharitis — Inflammation 

of the Eyelids; Prosis; Entropium; Ectropium 

Diseases of The Conjunctiva — Catarrhal Conjunctivi- 
tis; Purulent Conjunctivitis; Parenchymatous Con- 
junctivitis; Follicular Conjunctivitis Diseases of The 

Lachrymal Apparatus Diseases of The Cornea — 

Keratitis; Superficial Keratitis; Pannus Keratitis; 
Parenchymatous Keratitis; Wounds of the Cornea; 
Ulceration of the Cornea; Leukoma; Iritis; Cyclitis 

Diseases of The Crystalline Lens — Cataract 

"Diseases of The Retina and Optic Nerve Amauro- 

tis Periodical Opthalmia — Moon- Eye; Chronic 

Changes Due to Recurrency. 

CHAPTER II— Diseases of The Head 33-86 

Diseases of The Skin and Subcutaneous Tissues of The 

Head — Wounds Wound Infectious Diseases — 

Phlegmon; Malignant Oedema Dermititis — Super- 
ficial Dermatitis; Suppurative Folliculitis Diseases 

of The Muscles and Nerves of The Head — Facial 

Paralysis; Paralysis of the Trigeminal; Trismus 

Diseases of The Nasal Cavities and Sinuses — Chronic 
Nasal Catarrh; Necrosis of the Turbinated Bones; 
New Formations in the Nasal Cavity; Foreign Bodies 

in the Nasal Cavity; Fracture of the Nasal Bones 

Diseases of The Sinuses — Hydrops; Empyema; New 
Formations of the Sinuses; Diseases of the Teeth; 
Shear Mouth; Step Mouth Diseases of The Indi- 
vidual Teeth — Caries; Alveolar Periostitis; Tooth 
Fistula; False Tooth Fistula; Extracting Teeth; Frac- 
ture of the Lower Jaw; Actinomycosis in the Region 

of the Lower Jaw Diseases of The Tongue — Acute 

Glossitis Actinomycosis of The Tongue — Wooden 

Tongue; Fracture of the Hyoid Bone; Paralysis of 
the Tongue Diseases of The Pharynx — Pharyn- 
gitis; New Formations in the Pharynx Diseases 

of The Guttural Pouches — Catarrh of the Guttural 



vi Table of Contents 

PAGES 

Pouches Diseases of The Ear — Ulceration of the 

Ear Otitis Externa — Canker; Otitis Media 

Diseases of The Parotid Gland — Salivary Fistula; 
Salivary Concrements; Fistula of the Ear; P'racture of 

the Skull Diseases of The Neck — Wounds; Jugular 

Fistula; Goiter; Poll Evil; Fracture of the Cervical 

Vertebrae Diseases of The Larynx and Trachea — 

Roaring; New Formations in the Larynx; Stenosis of 

the Trachea Diseases of The Oesophagus — Choke 

or Stenosis Dilatation of The Oesophagus — Diver- 
ticulum Perforation of The Oesophagus — Rupture; 

Paralysis of the Oesophagus. 

CHAPTER III — ^DiSEASES of The Shoulder 87-127 

Shoulder Lameness — Acute Omarthritis; Chronic Omar- 
thritis; Chronic Changes in the Joint; Traumatic 
Myositis of the Shoulder Muscles; Rheumatic Myosi- 
tis; Bursitis Inter tubercularis; Fracture of the Scapula 
and Humerus; Paralysis of the Suprascapular Nerve; 
Radial Paralysis; Thrombosis o^ the Axillary and 

Humeral Arteries Diseases of The Elbow and 

Forearm — Shoe Boil; Inflammation of the Radio- 
Humeral Articulation; Fracture of the Radius and 

Ulna; Fracture of the Ulna Diseases of The Carpus 

— Wounds; Knee Boil; Acute Arthritis of the Carpus; 
Chronic Arthritis of the Carpus; Hygroma Formation 

on the Corpal Joint Diseases of The Metacarpus — 

Splints; Tendonitis; Stiltfoot; Stiltfoot in Foals; 
Rupture of the Flexor Tendons; Fracture of the Meta- 
carpus; Scratches; Foot Rot in Sheep and Cattle; 
Fracture of the First Phalanx; Periostitis on the 
Dorsal Surface of the Os Suffraginis; Osteomyelitis 
of the Os Suffraginis; Diseases of the Coronary Band; 
Sub-Coronary Phlegmon; Distortion of the Coffin 
Joint; Ring-Bone; Fracture of the Second Phalanx; 
Podoarthritis; Podo-trochlitis; Suppurative Inflamma- 
tion and Necrosis of the Third Phalanx and the Nav- 
icular Bone. 

CHAPTER IV— Diseases of The Thorax and Ab- 
domen 128-180 

Wounds — Rupture of the Seratus Magnus; Shoulder 
Abscesses Shoulder Fistula — J'istula of the With- 
ers; Fracture of the Ribs; Fistula of the Ribs; Sternal 
Fistula Diseases of The Abdomen— Wounds; Per- 



Table of Contents vii 

PAGES 

forating Abdominal Wounds; Intestinal Fistula; Um- 
bilical Hernia; Inguinal and Scrotal Hernia; Hernia 
Ventralis; Diseases of the Rectum; Proctitis; Pro- 
lapsus Recti; Fistula of the Rectum; Stenosis of the 
Rectum; Paralysis of the Rectum; Calculi in the 
Bladder and Urethea; Cryptorchidy; Operation for 

Cryptorchidy; Orchitis Diseases of The Spermatic 

Cord — Fistula of the Spermatic Cord or Schirrus 
Cord; Hydrocele; Diseases of the Scrotum and 
Sheath; Balanitis; Inflammation of the Prepuce in the 

Ox; Phimosis and Paraphimosis Diseases of The 

Penis — Paralysis of the Penis; Diseases of the Female 
Genital Organs; Vaginitis; Prolapse of the Vagina; 

New Formations in the Vagina; Hermaphrodism 

Occlusion of The Vagina Injuries to The Uterus — 

Metritis; Catarrhal Endo Metritis; Septic Metritis; 
Prolapsus Uteri; Torrio Uteri; Retention of the 
Placenta Diseases of The Mammary Gland — Mas- 
titis; Oedema and Phlegmon of the Udder; Abscess 
of the Udder; Catarrhal Mastitis; Parenchymatous 
•Mastitis; Septic Mastitis; Gangrenous Dermatitis of 
the Udder; Infectious Gangrenous Mastitis; Stenosis 
and Obliteration of the Teat Canals; Milk Fistula; 
New Formation in the Udder. 

CHAPTER V — Diseases of The Vertebrae, Tail 

AND Pelvis 181-190 

Crural Paralysis — Ante Partum Paresis; Post Partum 
Paresis; Fracture of a Dorsal or Lumbar Vertebrse; 
Fracture of the Pelvis; Fracture of the Sacrum; Lux- 
ation of the Sacrum Lumbago — Myositis of the 

Croup-Muscles; Thrombosis of the Iliac and Femoral 
Arteries. 

CHAPTER VI — Diseases of The Hip 191-224 

The So-Called Hip Lameness — Coxitis; Luxation of the 
Femur; Fracture of the Femur; Myositis of the 
Femoral Muscle; Paralysis of the Quadriceps Femoris; 

Bursitis Trochanterica Diseases of The Stifle — 

Acute Gonitis; Chronic Deforming Gonitis; Luxation 
■ of the Patella; Luxation of the Patella Upward; Bur- 
sitis Subpatellaris Diseases of The Lower Portion 

of The Hind Leg — Wounds and Phlegmon; Sub- 
fascial Phlegmon; Contusions of the Tibia; Fracture 
of the Tibia; Rupture of the Tendon of Achilles 



viii Table of Contents 

PAGES 

Diseases of The Hock Joint — Spavin; Injuries to the 
Joint and Surrounding Synovial Membranes; In- 
flammation of the Tendon .Sheaths in the Region of 
the Hock; Peri Arthritis of the Hock; Galls in the 
Region of the Joint; Capped Hock; Curb; String- 
halt Diseases of The Hoof — Podo-dermatitis; Sup- 
purative Podo-dermatitis; Laminitis; Nail Puncture; 
Nail Prick; Corns; Quittor; Side Bones; Thrush. 

CHAPTER VII— Surgical Diagnosis 225-260 

History — Examination; The Age of the Animal; Sex; 
Color; Weight; Constitution; Inspection; Healing by 
First Intention; Healing b?'' Second Intention; Palpa- 
tion; Temperature; Sensibility; Consistency; Crep- 
itation; Abnormal Movement; Compressibility; Puls- 
ation; Probing; Percussion; Ausculation Diagnostic 

Operations — Puncture; Cocaine Injections; Trepana- 
tion; Extirpation; Resection; Special Diagnosis of the 
Eye; Eyelid; Conjunctiva; Bulb; Cornea; Anterior 
Chamber of the Eye; The Iris and the Pupil; Posterior 
Chamber of the Eye; Lens; Retina; Examination of 
the Pupil and Lens with the Mirror; Palpation of the 

Eyeball Examination of The Sinuses and Nasal 

Cavity — Inspection; Percussion; Ausculation; Exam- 
ination of the Mouth Cavity; Examination of the 
Neck; Examination of the Thorax; Special Examina- 
tion for Lameness; Diagnostic Cocaine Injection 

Special Examination of The Shoulder — Shoulder 
Lameness; Examination of the Carpus; Examination 
of the Flexor Tendons; Examination of the Hoof; 
Examination of the Sole; Examination of the Frog; 
Examination of the Coronary Band; Palpation of the 
Hoof; Percussion of the Hoof; Mensuration; Exam- 
ination of the Urinary Tract; Examination of the 
Croup or Hind Quarter; Rectal Examination; Exam- 
ination for Prolapse of the Vagina; Examination of 
the Hock Joint Prescriptions. 



CHAPTER I 

DISEASES OF THE EYE 

DISEASES OF THE ORBIT 

Retro-Bulbary Phlegmon 

RETRO-BULBARY PHLEGMON is a condition in 
which the tissues surrounding the eyeball becomes 
■ involved in the formation of a phlegmon, which fre- 
quently results in the formation of an abscess. 

• Cause — The causes of this condition are either primary 
or secondary. The most important primary or direct cause 
is injuries or wounds, with or without infection. Secondary 
causes would be the spreading of an inflammatory condition, 
or an infectious process by continuity, from the surround- 
ing tissues. 

Forms — This condition appears in two forms depending 
upon the presence or absence of infection. The forms there- 
fore would be septic and aseptic. 

Symptoms — The sj^mptoms of both forms appear about 
the same clinically. The eyelids and the tissues surround- 
ing the eyeball become swollen and oedematous. This 
swelling is hot, painful, and shows all of the symptoms of 
an acute inflammatory condition. This swollen condition 
frequently becomes so severe that the lids are nearly shut 
and the mucous membrane of the lid becomes inverted, so 
that it shows itself very distinctly between the edges of the 
lids. When this condition afifects the fatty cushion of the 
eye, it causes the eyeball to be protruded from the orbital 

2 



lo The Practice of Veterinary Surgery 

fossa. On examination of the conjunctiva it is found to be 
reddened, sensitive and swollen. 

In the septic form of this disease, symptoms of abscess 
formation are noticed in this region. After a few days 
such general symptoms as rapid pulse, an elevation of tem- 
perature and the animal refusing food will be noted. All 
of the symptoms presented by the animal are more severe 
in this form. 

Rarely does the abscess evacuate spontaneously without 
very severe symptoms. After the contents of the abscess 
are evacuated healing takes place by second intention and 
the symptoms gradually disappear. It may occur that the 
abscess points inwardly instead of pointing toward the out- 
side of the body, in which case death results from meningitis 
and pyemia. 

Course — The course of this condition is usually acute, 
but may run a course of several weeks. 

Treatment — The treatment depends upon the form of 
the disease existing. In the aseptic form, moist warmth in 
the form of hot packs, antiphlogistics, or poultices, are the 
most effectual. If it is not practicable to apply moist 
warmth antiseptic ointments and lotions may be applied with 
massage; as boric acid ointment, ichthyol ointment, iodine 
ointment, etc. 

In the septic form, open the abscess as early as possible. 
Give drainage and disinfect with some non-toxic, non- 
irritating antiseptic, as potassium permanganate, boric acid, 
etc. Internal treatment is of very little value. 

WOUNDS OF THE EYELIDS 

In the horse, lacerated wounds of the eyelid occur very 
frequently. This condition is seen in other animals but is 
less common. Other wounds seen on and in the region of 



The Practice of Veterinary Surgery ii 

the lid are bruises, contusions and decubitus as the result 
of traumatic injuries from being cast, etc. It is not 
uncommon to have septicaemia, following the last named 
injuries. 

In treating lacerated wounds of the lids, great care 
must be exercised, for in suturing the act of puncturing the 
skin with the needle causes the animal to jerk or move the 
head, and if care is not exercised there is some danger of 
puncturing the eyeball. 

It is not advisable to remove any apparent excessive 
tissue from flap wounds of the lids, as these wounds heal 
with remarkable rapidity and very rarely leave any unsightly 
eschar, owing to their great power of regeneration. 

If these wounds give rise to a severe inflammation of 
the subcutaneous tissue they may be treated with a hot anti- 
septic pack, antiphlogistine, boric acid ointment, etc. 

If the tissues in the region of the lids are contused the 
treatment should consist of antiseptic lotion as a two per 
cent boric acid solution, one per cent solution of alum, 
one-half per cent solution of acetic acid or a one per cent 
solution of potassium perm.anganate. These solutions seem 
to be more effective when applied warm, and from fifteen 
to twenty minutes at each application. 

BLEPHARITIS 

Inflammation o£ the Eyelids 

Blepharitis is an inflammation of the eyelids. Clinically 
it appears in two forms, superficial and deep. Superficial 
blepharitis occurs most commonly and is an inflammation of 
the skin covering the lid. It is due chiefly to dermatitis, 
eczema, and mild irritations. A deep blepharitis eflfects the 
deeper structures of the lid and is most commonly caused 
by phlegmons, which appear as a wound infectious disease, 
following bites, punctured wounds, necrosis and abscess 



12 The Practice of Veterinary Surgery 

formations. A necrotic condition of the lids may be caused 
by suppurative lachrymosis, decubitus, pressure necrosis from 
the halter or bridle, or from rubbing blisters on the lids. 

In dogs, blepharitis usually occurs as the result of eczema 
appearing on the margin of the lids, or from furunculosis 
appearing in the form of small pustules or cysts. 

Symptoms — The symptoms of blepharitis vary greatly 
and the symptoms of the cause predominate ; however, the 
lids become swollen, sensitive and reddened. 

Course — The course of blepharitis is either acute or 
chronic. 

Treatment — Eczematous blepharitis should be treated 
with antiseptic ointment applied freely with massage, as 
zinc ointment, ointment of balsam of Peru, ointment of 
yellow oxide of mercury, ichthyol ointment, etc. If the 
application of ointment is not practicable, solutions may be 
used to advantage, as ten per cent solution of calendula, ten 
per cent solution of balsam of Peru in alcohol, etc. 

The treatment of necrosis of the lids consists in extir- 
pating the necrotic area if possible. If this is not possible, 
cauterize with a five per cent solution of silver nitrate, 
followed by the application of a ten per cent solution 
of calendula or some non-irritating coal tar antiseptic. 

In furuncolosis the pustules should be opened and cau- 
terized with a ten per cent solution of silver nitrate. 

Phlegmonous blepharitis should be treated with anti- 
septic ointments or moist heat applied in the form of hot 
packs, antiphlogistic preparations or ariol paste. 

Ptosis 

Ptosis is a condition in which there is persistent droop- 
ing of the upper eyelid. Ptosis very rarely occurs as a 
primary condition but is usually seen to occur secondarily 



The Practice of Veterinary Surgery 13 

to some other disease or as a symptom of a disease. It is 
most commonly due to swelling or paralysis. 

Forms — Ptosis appears in two forms and these can be 
distinguished very readily. They are true and false. 

In true ptosis there is a paralysis of the orbicularis oris 
muscle as well as the other muscles of the lids, while in false 
ptosis there is a drooping of the lid as a result of swelling. 

True ptosis generally appears as a symptom of, or during 
the course of some other disease, as facial paralysis in the 
horse, or milk fever in the cow. It is also seen as a symptom 
of central facial paralysis in dourine. 

False or pseudo ptosis consists in a severe swelling or 
an oedematous infiltration of the lids, causing a mechanical 
drooping. This is seen as the result of injuries or second- 
arily to some other disease. 

Treatment — If ptosis appears as a symptom of or during 
the course of some other disease, treatment is not indicated, 
as it will disappear with the disease of which it is a symptom. 
However, it may occur that ptosis will assume a chronic 
form, in which case it requires surgical treatment. This 
consists in the removal of an elliptical piece of skin from 
the center of the upper lid under the strictest antiseptic con- 
ditions. Suture the free edges of the wound and the lid will 
return to its normal condition. The exact size of this piece 
of skin to be removed cannot be given, as it depends upon 
the individual case. It is best to hold up a given amount 
of skin and see how much is necessary to give results before 
it is removed. It is essential to have healing by first inten- 
tion for a successful operation. 

Entropium 

Entropium is a change in the condition of the eyelid in 
which the outer border of the lid turns toward the cornea 



14 The Practice of Veterinary Surgery 

and the hairs on the free border of the lid come in direct 
contact with the cornea and conjunctiva. ' 

Occurrence — This condition is seen to occur most com- 
monly in young animals, as the pup and colt. It may occur 
in animals of any age. One or both lids may be affected, 
although the upper lid is 'affected most frequently. 

Cause — The most common cause producing this con- 
dition is chronic conjunctivitis. As the result of chronic 
irritation to the conjunctiva, during chronic conjunctivitis, 
new connective tissue is produced with an hypertrophy of 
the muscles of the lid. This new formed connective tissue 
is cicatricial in character. This eventually contracts with a 
resulting contortion of the lids. Entropium may also be 
caused by the muscles of the eye undergoing spasmodic 
contraction. This is not seen to occur commonly in the 
horse, but is the most common cause in the dog. 

Entropium is also seen to occur at the removal of or 
following an atrophy of the eyeball. This condition has also 
been seen to occur as a congenital affection or defect. 

Symptoms — The edge of the e3^elid seems to turn in so 
that the hairs on the border of the lid irritate the conjunctiva 
and cornea. As the result of this continual irritation, there 
appears lachrymosis, photophobia, conjunctivitis, and keratitis. 
Eventually, after the irritation has become chronic, ulceration 
of the cornea and chronic keratitis with leucoma formation 
appear. 

Treatment — The treatment of this condition is operative 
and consists in removing an elliptical piece of skin from the 
center of the lid as in ptosis. If both lids are affected, the 
operation must be performed on both lids. The pieces of 
skin must be removed under the strictest antiseptic precau- 
tions. When the free edges of the wound are sutured, the 
lid will return to its normal condition. 



The Practice of Veterinary Surgery 15 

After the operation the conjunctivitis and keratitis 
should be treated with yellow oxide of mercury ointment, 
ichthyol ointment, warm boric solution, four per cent, etc. 

Ectropium 

Ectropium is a condition in which the free border of 
the eyelid is turned outward. From a veterinary stand- 
point, this is a very unimportant condition as it very rarely 
occurs in practice. If it does occur it is seen in older 
animals and chiefly then in the dog, rarely in the horse. 

Cause — Ectropium is sometimes congenital, but usually 
follows conjunctivitis in which the conjunctiva is left greatly 
thickened, or there is an increased amount causing mechani- 
cal ectropium. 

Treatment — The treatment is operative in acquired cases 
and expectative in congenital cases. If the conjunctiva is 
greatly thickened or increased in amount, it may be excised 
and treated with warm boric acid solution. If this does not 
give the desired results, remove an elliptical piece of skin, 
about one-half an inch from the canthi. When the free edges 
of the skin are sutured, it will have a tendency to draw 
the lids to their normal condition. Healing by first intention 
is essential. 

DISEASES OF THE CONJUNCTIVA 

Catarrhal Conjunctivitis 

Catarrhal conjunctivitis consists in a superficial inflam- 
mation of the conjunctiva, with the formation of a catarrhal 
or serous exude. This form of conjunctivitis appears in all 
animals. It may appear as a primary disease or as a symp- 
tom of some other disease. 



i6 The Practice of Veterinary Surgery 

Cause — The most common causes of catarrhal conjunc- 
tivitis appearing as a primary disease, are direct irritations 
by mechanical means, as splinters, briars, hayseed, hair, dust, 
grain, pollen, or by chemical agents as alcohol, bichloride, 
rubbing blisters, etc., or by thermic agents as burning, 
extremely liot weather, freezing, etc. While these are the 
most common causes, it may also be due to parasites. When 
it is parasitic in origin it is unilateral, otherwise it appears 
as a bilateral afifection. 

Catarrhal conjunctivitis occurs as a symptom during the 
course of some contagious and infectious disease, as dog 
distemper, contagious pleuro-pneumonia, contagious corhyza, 
influenza, periodical opthalmia, malignant head catarrh, etc. 
In dogs, the disease sometimes appears in old age and does 
not seem to have any specific cause. 

Symptoms — The symptoms of catarrhal conjunctivitis 
appear with a serous or watery discharge from the eyes, the 
animal keeps the lids closed as the presence of light seems 
to be very irritating. The conjunctiva is swollen, reddened 
and painful on pressure. The conjunctiva frequently becomes 
so greatly swollen that it is visible between the lids. As 
the disease progresses the discharge becomes admixed with 
mucus. 

Treatment — The treatment consists in the application of 
mild astringent washes to the conjunctiva, as one per cent 
solution of alum, two per cent solution of boric acid, one 
per cent solution of zinc sulphate, or ichthyol. If the con- 
junctiva is hyper-sensitive, a few drops of a four per cent 
solution of cocaine may be dropped directly into the con- 
junctival sack. In the earlier stages of this disease a few 
drops of adrenalin solution (1/10,000) will be found very 
useful in allaying the congestion. 



The Practice of Veterinary Surgery 17 

Purulent Conjunctivitis 

Purulent conjunctivitis is a suppurative inflammation of 
the conjunctiva as the result of infection. 

Cause — The most common cause of purulent conjunc- 
tivitis is an infection of the conjunctiva with ordinary pus 
cocci, or it may be due to a specific infection as in dog dis- 
temper, or malignant head catarrh. 

The entrance of the infection to the conjunctiva may 
take place in various ways as by mechanical means, by rub- 
bing, or by the entrance of a foreign body into the conjunctival 
sack, etc. 

Purulent conjunctiA^tis may occur as the result of the 
entrance of a foreign body, but this is not common in practice. 
If due to a foreign body in the conjunctival sack, it appears 
as a unilateral affection. 

Symptoms — The symptoms of purulent conjunctivitis 
appear with a purulent or suppurative discharge from the 
eyes, scabs, or crusts form on the edge of the lids, some- 
times causing the lids to be pasted together. The conjunc- 
tiva is very pale. This constitutes a diagnostic symptom. 
After this disease has existed for some time, the suppurative 
process spreads to the lids and cornea, giving rise to eczema 
or furunculosis and keratitis. 

Course — The course of this disease is usually long drawn 
out, assuming a chronic form. 

Treatment — The treatment consists of applying anti- 
septic solutions and ointments to the conjunctival sack, as 
chinosol (1/1000), one per cent solution of ichthyol, one-half 
per cent solution of cresol, one per cent solution of copper 
sulphate or zinc sulphate, yellow oxide of mercury ointment, 
etc. Before treatment is administered it is very essential 
to examine the conjunctival sack for the presence of a 



1 8 The Practice of Veterinary Surgery 

foreign body. This is especially true of unilateral purulent 
conjunctivitis. 

Parenchymatous Conjunctivitis 

Parenchymatous conjunctivitis is an inflammation of the 
entire structure of the conjunctiva, especially the deeper 
layers. It consists in a severe traumatic or infectious in- 
flammatory process. 

Occurrence — It appears as a primary disease from the 
spreading of an inflammatory process by continuity, or as a 
symptom of some other disease. 

If due to infection, the infection enters the deeper struc- 
tures by way of the blood or lymph stream. In these cases 
it generally appears as the symptom of some other disease. 

Symptoms — The chief and diagnostic symptom is a very 
firm, glassy swelling of the conjunctiva. After a few d/ays 
the inflammatory process spreads, involving the sclera. 
There is a serous or sero mucous discharge from the eye. 
In exceptional cases the discharge becomes purulent. 

Course — The course of this disease is acute. If heal- 
ing does not take place promptly the conjunctiva becomes 
necrotic. 

Treatment — The treatment consists in the application of 
cooling antiseptic astringent washes, as one per cent solution 
of alum, etc. If the swelling of the conjunctiva becomes 
severe, it becomes necessary to scarify the superficial layers. 

Follicular Conjunctivitis 

Follicular conjunctivitis consists in a severe chronic 
swelling of the lymph follicles and connective tissue on the 
inner surface of the membrana nictitans. 



The Practice of Veterinary Surgery 19 

This disease is seen to occur mostly in dogs, but may- 
appear in any animal. 

Cause — The exact cause is unknown. 

Symptoms — The membrana nictitans becomes red and 
swollen. By examining it after the disease has existed for 
some time, there will be found small dark red ulcerations 
on the inner surface. These ulcerations later on become 
confluent, forming distinct nodules. The membrane nicitans 
protrudes from the inner canthus, resembling somewhat a 
small turiiefaction. There is rarely any discharge from the 
eye afifected. 

This condition may spread to the conjunctiva by con- 
tinuity, in which case it leads to cicatrization with the 
formation of entropium. 

Course — The course of this disease is chronic. 

Treatment— The most satisfactory treatment consists in 
removing the entire membrana nictitans. Grasp the mem- 
brane with an artery forcep, or small vulsellum forcep, draw 
it out as far as possible and remove with the scissors. The 
entire membrane must be removed to give the desired results. 
Other forms of treatment consist in cauterization with a 
five per cent solution of silver nitrate, immediately followed 
with salme solution. This form of treatment is not very 
satisfactory, from a clinical point of view. After removing 
the membrana nictitans instill five to ten drops of warm boric 
acid solution into the eye three times daily. If the conjunc- 
tiva is involved, place a small amount of yellow oxide of 
mercury ointment directly between the lids. 

DISEASES OF THE LACHRYMAL APPARATUS 

The only disease of the lachrymal apparatus that is of 
clinical importance is a catarrhal condition of the lachrymal 
sack and duct. This consists in a chronic catarrhal in- 



20 The Practice of Veterinary Surgery 

flammation, caused by a stricture or stoppage of the naso- 
lachrymal duct. 

Symptoms — The symptoms of catarrh of the lachrymal 
sack consists in the flowing of tears over the face instead of 
through the naso-lachrymal duct. This irritates the con- 
junctiva, and after the disease exists some time, conjunctivitis 
appears, which is acute in character. 

Course — The course of this disease is chronic. 

Treatment — The treatment consists in irrigating the 
lachrymal sack, through the naso-lachrymal duct, with mild 
antiseptic astringents, as zinc sulphate one per cent, alum 
two per cent, etc. This irrigation can be carried out with 
a small syringe, or a bulb syringe, through the nasal opening 
of the naso-lachrymal duct. 

DISEASES OF THE CORNEA 

Keratitis 

Diseases of the cornea are divided into suppurative and 
non-suppurative, from a clinical point of view; however, there 
may be another division according to the part of the cornea 
affected, that is superficial, parenchymatous and posterior 
keratitis. 

Superficial Keratitis 

Superficial keratitis is an inflammation of and involves 
the superficial portion of the cornea and the reflection of the 
conjunctiva over the cornea. 

Cause — The chief causes are mechanical irritations from 
external sources, which either comes directly in contact with 
the cornea or lodges between the folds of the conjunctiva, 
thus irritating the cornea. This disease has been known to 



The Practice of Veterinary Surgery 21 

occur by metastasis, but is extremely rare, in which case it 
is suppurative in character. 

Forms — Superficial keratitis appears in two forms, ca- 
tarrhal and suppurative. 

Symptoms — The symptoms of superficial catarrhal kera- 
titis consist in swelling of the cornea with desquamation of 
the epithelium. The cornea is rough and opaque in appear- 
ance, and there is a catarrhal discharge from the eyes. This 
form of keratitis is most commonly seen in practice. 

In superficial purulent keratitis the surface of the cornea 
is yellow and roughened. In some cases the entire cornea 
does not become yellowish in color, but yellow spots appear 
over the surface of the cornea. This form of keratitis very 
rarely appears primarily, but is seen either as the result of 
or during the course of some other disease. 

Treatment — The treatment of superficial catarrhal kera- 
titis consists in the use of yellow oxide of mercury ointment, 
ichthyol ointment or mild astringent antiseptic washes. 

In superficial purulent keratitis, yellow oxide of mercury, 
one per cent solution of chinosol, or eucamphol should be 
instilled directly into the conjunctival sack. 

Pannus Keratitis 

Pannus keratitis is characterized by thickening and 
roughness of the cornea, with resulting vascularization. The 
cornea becomes covered with new formed blood vessels, 
leading from the border to the center, which are visible to 
the naked eye. 

Cause — This condition generally results from purulent 
keratitis, accompanied by ulceration in which there is an 
attempt on the part of nature to repair by means of granu- 
lation. After healing there is left over a cicatrix (leucoma). 



22 The Practice of Veterinary Surgery 

Symptoms — There are symptoms of photophobia and 
lachrymosis present in a marked degree. There is also a 
catarrhal or muco-purulent discharge from the eye. The 
cornea is rough and contains numerous small visible blood 
vessels. 

Course — The course is chronic as a rule. 

Treatment — The use of red oxide of mercury ointment 
is very valuable in the treatment of this disease. It should 
be placed directly into the conjunctival sack. Two per cent 
solution of quinine sulphate or yellow oxide of mercury oint- 
ment may also be used. The value of mild astringents is 
doubtful in these cases. 

Parenchymatous Keratitis 

This is an inflammation of the deeper or interstitial 
structures of the cornea and involving the true layers of the 
cornea itself. It consists in a thickening of the cornea from 
new formed connective tissue along with the entrance of pus 
cocci, or some specific infection into the cornea. 

Cause — The cause of this disease is infection. The 
infection can gain entrance either directly from external 
sources or indirectly by metastasis. 

Symptoms — The symptoms are divided into two classes, 
those that appear in the form of an infiltration and those 
leading to abscess formation. 

In cases of very mild infection there is an infiltration of 
the cornea causing a diffused or circumscribed opaqueness. 
This condition is of very short duration, as absorption occurs 
or abscess formation exists. 

An abscess is usually the result of direct infection. An 
abscess on the cornea presents a yellowish area about the 
size of a radish seed and very sharply defined. The course 
of this condition is about one week and terminates either in 



The Practice of Veterinary Surgery 23 

absorption with cicatricial formation, or it suppurates, dis- 
charges and leaves behind an ulcerating surface. 

Treatment — The treatment of infiltration of the cornea 
as the result of infection, consists in using yellow oxide of 
mercury ointment, while abscesses should be punctured and 
cauterized with silver nitrate immediately followed by saline 
solution. 

Wounds of the Cornea 

Wounds of the cornea appear quite commonly in horses 
and dogs, but are rarely seen in other animals. 

Cause — Wounds of the cornea are caused by the animals 
being injured or coming in contact with sharp objects. They 
may also be caused by burning or cauterization, but not 
commonly. 

According to the location these wounds are classified as 
superficial, deep or completely perforating. Perforating 
wounds are usually found on the upper part of the cornea, 
near the sclera. 

Symptoms — The symptoms of wounds of the cornea are 
photophobia, lachrymosis, pain on pressure, swelling and heat 
in the region of the affected eye. In perforating wounds it 
frequently occurs that the posterior chamber of the eye be- 
comes infected and suppurates. 

Wounds of the cornea that are not infected heal rapidly, 
leaving a small cicatrix. Those that are infected generally 
lead to ulceration. Perforating wounds sometimes lead to 
the formation of anterior synechia. 

Treatment — The treatment of these wounds consists in 
instilling into the eye warm boric acid solutions. If there 
is great pain and photophobia present, use a few drops of 
cocaine solution. Any metallic preparation is strictly contra- 
indicated, because the metallic base in contact with the free 



24 The Practice of Veterinary Surgery- 

surface of the wounds leads to the formation of an albu- 
minate with a resulting leukoma. 

Ulceration of the Cornea 

Ulceration of the cornea is characterized by a chronic, 
circumscribed, progressive, suppurative inflammation of the 
cornea. 

Occurrence — Ulceration of the cornea very rarely occurs 
primarily, but is seen most commonly as a symptom of or 
during the course of some other disease, in which case it 
appears partly from decreased vitality and partly from infec- 
tion. Ulceration of the cornea may appear as a symptom 
in the following diseases: Diabetes, influenza, poisoning 
from cotton seed meal and suppurative keratitis. 

Symptoms — In ulceration of the cornea the remaining 
portions of the eye generally remain intact, although in some 
cases there may be found posterior synechia or suppurative 
panopthalmia. 

There appears on the cornea a small bluish area, which 
is rough, somewhat resembling ground glass in appearance. 
This is the ulcer itself. 

Non-perforating ulcerations heal by means of vascular- 
ization from the periphery of the cornea to the ulcer. As a 
result of the ulcer healing there is a leukoma found, which 
is a cicatrix. 

Course — The course of ulceration of the cornea is 
chronic. 

Treatment — The treatment of ulceration of the cornea 
is prophylactic in symptomatic cases, unless the ulcers be- 
come indolent, when a few drops of warm boric acid or one 
per cent creolin solutions may be instilled into the eye. 

Chronic indurating ulcers should be cauterized with a 
five per cent solution of silver nitrate, applied with a camel's 
hair brush, followed by a saline solution. 



The Practice of Veterinary Surgery 25 

It is usually advisable to give some general treatment, 
as potassium iodide, arsenic or iron preparations. 

Leukoma 

A leukoma consists of any chronic incurable opacity of 
the cornea causing it to become opaque. It consists of a 
cicatrix in the matrix or on the surface of the cornea. This 
opacity has the appearance of ground glass and may be any 
color due to the absorption of pigment. 

Leukomas are not defects unless they occur over the 
pupil or interfere with the sight of the animal by covering 
large areas. 

A leukoma is practically an incurable condition, when 
once completely formed, but forming may be partially relieved 
by putting calomel or red oxide of mercury directly against 
the cornea. If a leukoma is very superficial it may be 
removed with a knife. From a cosmetic standpoint they may 
be tattooed with India ink and in this manner be made 
invisible. 

Iritis 

Iritis is an inflammation of the iris. 

Cause — Iritis rarely appears as a primary disease, but 
appears during the course of, or as a symptom of, some other 
disease. 

Symptoms — The symptoms of iritis consist in the pres- 
ence of a fibrinous exudate in the anterior chamber of the eye. 
This exudate consists of a yellowish floculent mass, somewhat 
resembling butter. This may be discolored by the addition 
of blood. If this exudate becomes purulent it gravitates and 
appears on the floor of the anterior chamber of the eye as a 
greenish mass. 

The iris itself is changed in appearance. In very acute 
conditions it becomes swollen and injected, and as a result 

3 



26 The Practice of Veterinary Surgery 

of the swelling, the pupil appears like a slit and does not 
respond to light. 

In chronic adhesive iritis, as seen in periodical opthalmia, 
the iris becomes adherent to the lens, forming posterior 
synechia. As the result of posterior synechia, the iris is torn, 
causing the outline of the pupil to become irregular. When 
the pupil is dilated, small particles of the iris will be found 
to be adhering to the lens. 

In traumatic iritis the iris becomes adherent to the cornea, 
forming anterior synechia. 

In iritis there are found such other symptoms as photo- 
phobia, lachrymosis, conjunctivitis and marked injection of 
the episcleral vessels. 

Course — The course of iritis is acute, but may lead to 
chronic changes in the eye. 

Treatment — The treatment consists in instilling solutions 
of atropine and cocaine into the eye. Moist heat applied 
externally and potassium iodide internally will be found very 
serviceable. 

Cyclitis 

Cyclitis consists of an inflammation of the ciliary bodies. 

Cause — Cyclitis is generally symptomatic and is caused 
by the spreading of an inflammation from the cornea and iris. 
It may occur primarily from a very severe injury, but only 
rarely. 

Symptoms — Iritis is seen most commonly as a symptom 
of periodical opthalmia ; it very rarely appears as such. 
Cyclitis presents the following symptoms : Photophobia, 
pain on pressure over the eye, swelling of the iris, opacity 
and swelling of the crystalline lens, and injection of the 
conjunctiva. In severe cases that become prolonged, there 
is luxation of the lens, atrophy of the bulb, and the formation 
of posterior synechia. 



The Practice of Veterinary Surgery 27 

Course — The course of cyclitis is acute or chronic. 

Treatment — The treatment consists in dropping a few 
drops of atropine solution into the conjunctival sack, and the 
application of moist heat externally. 



DISEASES OF THE CRYSTALLINE LENS 

Cataract 

By the term cataract is meant any condition which renders 
the crystalline lens opaque. 

Cause — A cataract is usually due to some regressive 
process of metabolism, which causes a diminished blood 
supply to the lens, with destruction of the cells, or the 
infiltration of the lens with foreign substances, as fat, lime 
salts or cholestrin. A cataract may also be due to some 
pathological condition of the epithelium on the external 
surface of the capsule of the lens. 

According to the cause the following forms of cataract 
must be described separately : Symptomatic, traumatic, 
senile, congenital, and diabetic. 

Symptomatic Cataract is the result of an inflammatory 
condition of the tissues surrounding the lens, which in turn 
lead to disturbances of nutrition of the lens, with the forma- 
tion of cataract. Symptomatic cataract also occurs during 
the course of, or as the result of, certain infectious and 
contagious diseases, as pleuro-pneumonia, influenza, dog 
distemper, malignant head catarrh, etc. In these cases it is 
undoubtedly also due to malnutrition. 

Following iritis there may be a circumscribed or partial 
opacity of the lens as the result of adhesions, or the spreading 
of an inflammatory condition. Following a very severe case 
of cyclitis there is usually a diffuse or total opacity of the 



28 The Practice of Veterinary Surgery 

lens. A very common form of symptomatic cataract is seen 
in moon blindness. 

Traumatic Cataract is the direct result of an injury to 
the lens itself, or the entrance of foreign bodies or parasites 
in the eye. The lens may be injured by a hard blow, or 
running into some stationary object with great force, causing 
luxation or subluxation with resulting cataract formation. 
This form of cataract may also follow severe exertions, 
causing increased blood pressure. A traumatic cataract forms 
very rapidly, and has been known to occur from a very severe 
injury, in from twenty-four to forty-eight hours. 

Senile Cataract can be diagnosed easily by the fact that 
the opacity in the lens begins to form in the center first and 
from this point the opacity becomes diffuse. This form of 
cataract is usually the result of a degenerative process, and 
is seen in old animals, especially old dogs. 

Congenital Cataract is one which is acquired during 
foetal life. It appears as a circumscribed opacity of the lens 
at the time of birth. This form of cataract does not change, 
but remains the same throughout life. 

Symptoms — The symptoms of cataract consist in an 
opacity of the lens and dilation of the pupil. The color of 
the opacity is usually whitish or yellowish, but may vary 
greatly. A partial cataract consists in an immovable opacity 
which only affects a portion of the lens. 

It is very hard to determine the exact length of time a 
cataract has existed, but as a general rule it requires about 
six weeks for a cataract to form completely. The exception 
to this is traumatic cataract. 

Treatment — The treatment of cataract in animals is prac- 
tically worthless. If the lens is removed as in man, the eye 
has lost its focusing power, and the animal will only be able 



The Practice of Veterinary Surgery 29 

to discern objects at certain given distances. From a cosmetic 
point of view the lens may be removed, or the cornea 
tattooed with India ink, to cover up the presence of the 
cataract. If the cataract is in the state of formation, internal 
treatment may check it. For this purpose preparations of 
iron, arsenic, iodine or mercury may be given. 

DISEASES OF THE RETINA AND OPTIC NERVE 

Amaurosis 

From a veterinary standpoint, amaurosis is the only 
important disease of the retina and optic nerve, or both, in 
which there are no apparent external changes in the eye itself. 
This condition is commonly known as "star gaze." 

Cause — The exact cause is unknown, but occurs second- 
aril}^ or symptomatically as a general rule. It occurs 
secondarily to and follows contagious diseases, intoxications, 
ptomaine poisoniings, neuritis, tuberculosis, tumors along the 
course of the optic nerve, diseases of the brain, etc. This 
disease has also been known to be congenital. 

From a pathological standpoint this paralysis is either 
total or partial, and affects either the optic center, optic nerve 
or the retina. 

Symptoms — The diagnostic symptom of amaurosis is a 
dilatation of the pupil which is constantly present. The 
pupil does not respond to light, and the reflection of light 
on the cornea is a characteristic sky blue. The retina is 
pale, atrophic and loosened, due to the paralysis. This con- 
dition of the retina can easily be seen with a mirror. 

The animal hold's the head to one side, stumbles and 
can be led into or against any object. The finger can be 
passed directly against the cornea, if the tactile hairs are not 
touched. 



30 The Practice of Veterinary Surgery 

Course — The course is chronic. 

Treatment — This condition is practically incurable, there- 
fore treatment is worthless. Strychnine may be used, but 
its therapeutic action in these cases is doubtful. 

PERIODICAL OPTHALMIA 

Moon-Eye 

Periodical opthalmia consists in a specific, non-suppura- 
tive, probably infectious panopthalmia of the horse. This 
disease is an inflammatory process affecting the entire eyeball 
and its appendages. 

Cause — The specific cause of this disease is unknown at 
present, but it is probably one of the following: Protozoa, 
cysticercus, bacillus, micrococcus, or staphylococcus. 

It is most likely a miasmatic disease. The infection 
seems to enter by way of the mouth, in the food and water, 
gains entrance into the circulation, lodging in the eye. A 
direct infection from animal to animal does not seem to take 
place. Artificial inoculation with the discharge from an 
infected animal will cause an attack of the disease in about 
forty-eight hours. 

Young horses seem to have a predisposition to this dis- 
ease, as it is seen to occur most frequently between the ages 
of three and six years. There is nothing definite known 
about the period of incubation. 

Occurrence — This disease seems to be stationary in cer- 
tain localities. It is generally seen to occur in animals that 
pasture on low. damp territory, along creek and river bottom 
and on marshy ground. In most instances there will be 
found a district where the disease is stationary. There may 
be an outbreak of the disease folloAving high water, with the 
lodging of debris on the pasture. 



The Practice of Veterinary Surgery 31 

Symptoms — The symptoms are divided into the acute 
attacks and the chronic changes in the eye as a result of the 
recurrence of the acute attacks. 

The symptoms of the acute attacks appear very suddenly. 
The owner will state that it came on over night. There are 
symptoms of severe photophoibia, lachrymosis, heat and pain 
on pressure over the eye. As a rule only one eye is affected. 
The conjunctiva is injected, swollen and the pupil contracted 
so that it appears like a slit. 

After, a few days there is seen the product of iritis on 
the floor of the anterior chamber of the eye. This is in 
the form of a yellow flufify body, resembling butter, about 
the size of a large navy bean. By examining the retina at 
this time it is found to be swollen, roughened, yellowish in 
color and no marked line of distinction between the tapetum 
lucidum and nigrum. 

The height of the disease is reached on the fourth or 
fifth day. After the resorption of the exudate begins, pain 
decreases, the discharge is lessened, and in from ten to fifteen 
days the eye apparently returns to normal. 

Chronic Changes Due to Recurrency 

The chronic changes due to recurrency of the disease 
appear after three to five acute attacks. The iris becomes 
adherent to the crystalline lens, the edges of the iris are torn 
and the outline of the pupil is very irregular. The crystalline 
lens becomes striped in appearance. Finally, there is atrophy 
of the iris, cataract formation and floating retina. The 
consistency of the eyeball is soft, there is marked atrophy of 
the eyeball, causing it to sink into the orbit. As the result 
of the eyeball sinking into the orbit the upper lid forms a 
triangle sometimes spoken of as the third canthus. The 
eyesight is impaired early in the course of the disease. 



32 The Practice of Veterinary Surgery 

Prognosis — The prognosis is always unfavorable, as it 
terminates in blindness. The attacks do not always appear 
with any regularity. They may be weeks or months apart, 
sometimes appearing closer together and at other times far- 
ther apart. 

Differential Diagnosis — Iritis. 

Treatment — The treatment is mainly expectative and 
symptomatic. Apply moist heat over the region of the eye 
in the form of hot water, Priesnitz packs or antiphlogistics. 

Solutions of cocaine and atropine should be distilled 
directly into the conjunctival sack. Internally, potassium 
iodide, arecoline or eserine should be given to assist in 
resorption. 

Probabl}^ the most satisfactory treatment consists in 
injecting five cubic centimeters of Lugol's solution into the 
fatty cushion, lodging the eye, immediately behind the eye- 
ball. This may be repeated, if necessary, in five days. It 
may give rise to some acute symptoms, but these subside 
within a few hours. 



CHAPTER II 

DISEASES OF THE HEAD 

DISEASES OF THE SKIN AND SUBCUTANEOUS 
TISSUES OF THE HEAD. 

Wounds 

WOUNDS are very common in the region of the lips, 
nose, cheeks, forehead, around the eyes, and ears. 
Wounds in the region of the head are more common 
in horses and dogs than in other animals. These wounds 
are generally contused or lacerated, but any kind of wound 
may occur. In dogs, punctured wounds from bites are not 
at all uncommon. 

Decubital gangrene frequently results from lacerated or 
contused wounds in the region of the head. 

As this part of the body is very vascular, these wounds 
have a tendency to heal with great rapidity, and do not have 
a tendency to scar formation. If the wounds are thoroughly 
cleansed, the hair and foreign bodies removed and sutured, 
healing takes place rapidly. These wounds have a tendency 
to heal by first intention if properly treated, especially in the 
region of the eye and false nostril. The proper method of 
suturing is the ordinary interrupted suture. In case too 
much strain comes on these sutures, a button or Bayer's 
suture may be applied. 

Wounds that are already suppurating and granulating in 
the region of the head heal very rapidly by third intention, 
if cleansed and sutured. 

These wounds are very much subject to infection, and 
as it is impossible to apply a bandage, some protecting oint- 



34 The Practice of Veterinary Surgery 

ment or paste should be applied; over the wound after suturing, 
so as to keep out infection, as ariol paste, ointment of zinc 
oxide, tannin, iodoform, lead acetate, or zinc sulphate. 

WOUND INFECTIOUS DISEASES 
Phlegmon 

Phlegmon is an inflammation of the connective tissues. 
This is seen to occur very frequently, and is probably the 
most common wound infectious disease occurring around 
the head. 

The phlegmon that appears in the region of the head is 
chiefly subcutaneous, but may be subfacial. The form of 
phlegmon will vary with the infection and may be suppurative 
or emphysematous. 

The most common seat of phlegmon around the head is 
in the region of the larynx, lips, cheeks and eyelids. 

Phlegmon may lead to necrosis formation, and if it does 
it will appear circumscribed and in the form of a penetrating 
ulcer in the region of the lips and cheeks. 

Treatment — The treatment consists in free incision, anti- 
septic irrigation and dusting powders, or ointments applied 
to the wound surface. 

Malignant Oedema 

Malignant oedema is a specific wound infectious disease. 
It may occur in any part of the body, but seems to occur 
most frequently in the region of the head and neck. 

Cause — The most common cause is punctured wounds 
that become infected with the malignant oedema bacillus. 

Occurrence — It occurs mostly in the horse and ox. 

Symptoms — This disease appears very suddenly and 
spreads rapidly. It presents the same symptoms as septic 



The Practice of Veterinary Surgery 35 

gas phlegmon. On palpation there is a peculiar crackling 
sound resembling emphysema. This disease leads to severe 
general symptoms. 

Prognosis — The prognosis is very unfavorable, most of 
the cases terminate in death either from asphyxia or oedema 
of the lungs and viscera. 

Course — The course is acute. 

Treatment — The treatment consists in making free in- 
cisions into the part affected with disinfection. It is thought 
that parenchymatous injections of boric acid or potassium 
permanganate solution is also very serviceable in the treat- 
ment of this disease. 

DERMATITIS 

Superficial Dermatitis 

Superficial dermatitis consists in an inflammation of the 
superficial structure of the skin. 

Cause — The most common causes of this condition are 
pressure, decubitus or burning, but it may be caused by any 

irritation or infection. 

Forms — Superficial dermatitis appears in three forms, viz : 
Erythematous, suppurative or hyperplastic. From a prac- 
tical standpoint, suppurative dermatitis is the most important 
form. This is seen to occur most commonly in the dog, the 
cause being infection. 

Symptoms — The skin becomes painful, hot and swollen. 
After a few days there is the formation of a greenish yellow 
suppurative exudate which causes the skin to become matted 
and form a crust. 

Course — The course of this disease is acute if properly 
treated. 



36 The Practice of Veterinary Surgery 

Treatment — The most important part about the treat- 
ment is removal of the cause and cleanliness. Keep the part 
clean by washinjj; with some antiseptic and soap. This may- 
be followed by the application of dusting powders or pref- 
erably ointments, as zinc ointment, bismuth subnitrate oint- 
ment, ichthyol or thiogenal ointment ; other ointments, as 
boric acid, tannin or salycilic acid, may be used, but are not 
as serviceable as the foregoing. 

Suppurative Folliculitis 

Suppurative folliculitis consists in a suppurative inflam- 
mation of the hair follicles and sebaceous glands. It is seen 
to occur mostly in the region of the mouth and nose, as well 
as the false nostrils. 

Cause — The most common cause is ordinary pus cocci. 

Forms — From a clinical point of view the following forms 
are diagnosed : Furunculosis of the nose in the dog, and 
folliculitis of the nose and lips in the horse. 

Furunculosis of the nose in dogs is due to infection and 
commonly appears from wearing a muzzle. 

Symptoms — The chief symptom consists in a great num- 
ber of small fluctuating pustules deeply seated in the skin, 
acco'mpanied by more or less thickening of the skin. As a 
rule there is a small circumscribed area affected, but under 
favorable conditions a very large area may become infected. 

Treatment — The treatment consists in opening the pus- 
tules, curetting or cauterizing with silver nitrate. If the 
cause can be found remove it at once. If the disease persists 
and will not yield to treatment it becomes necessary to 
remove the affected portion of skin. After removing the 
skin, suture and use every possible means to have healing 
by first intention. Ointments have very little action in 
these cases. 



The Practice of Veterinary Surgery 37 

Folliculitis of the nose and lips in horses most frequently 
occurs from an infection of glanders bacilli, but may be caused 
by ordinary pus cocci. It consists in a multiple, suppurative 
inflammation of the sebaceous glands. In severe or prolonged 
cases the disease spreads to the nasal cavity, involving the 
mucous glands. 

Symptoms — The symptoms consist in the formation of 
pustules and superficial ulcers. These often spread and 
involve the lymphatics, causing lymphangitis, and in some 
cases the lymph glands in intermaxillary space also become 
involved and undergo suppuration. 

Treatment — The treatment consists in incising the pus- 
tules, disinfecting, cauterizing the ulcers with antiseptic treat- 
ment of the suppurating- lymphatics with the subcutaneous 
injection of bacterins. 

DISEASES OF THE MUSCLES AND 
NERVES OF THE HEAD 

Facial Paralysis 

Facial paralysis appears in two forms in practice; they 
are central facial paralysis and peripheral facial paralysis. In 
general the cause of this condition is undoubtedly some 
irritation to the nerve center, nerve trunk or nerve endings. 

Central facial paralysis usually appears as a bilateral 
afifection in practice, although it may be unilateral, while peri- 
pheral facial paralysis generally appears as a unilateral 
afTection. Peripheral facial paralysis is the form most com- 
monly seen in practice. 

Cause — The causes of central facial paralysis are new 
formations, abscesses, hemorrhages or thrombi affecting the 



38 The Practice of Veterinary Surgery 

center, appearing in the cranial cavity. This disease often 
appears as a symptom of an infectious or intoxicating process 
as glanders and dourine. 

The causes of peripheral facial paralysis are contusions 
or injuries to the nerve trunk from halter pressure, being cast 
or flouncing during colic, or lying so that the face is on some 
hard object for a long time. It has been known to occur 
from catching cold. 

Symptoms— The symptoms of peripheral facial paralysis 
usually appear on one side of the face. There is a unilateral 
paralysis of the lips, nose and cheeks. The upper lip is 
noticeably drawn around to the affected side, while the lower 
lip is not so noticeably affected. There is more or less 
disturbance in eating and drinking, especially in prehension. 
There is an accumulation of food between the teeth and cheek 
on the affected side. In most cases the muscles of the ear 
become affected, causing the ear to lop to one side. There 
may be more or less ptosis present. This is not a constant 
symptom. 

In bilateral peripheral facial paralysis, the muscles on 
both sides of the face become paralyzed. The face has a 
flat, expressionless appearance, the lips hanging, and the 
nostril seems to be very small, owing to the fact that the 
false nostril is collapsed. At every inspiration the false 
nostril drops or falls into the opening of the nostril, with 
severe dyspnoea resulting. As a rule this is a very serious 
condition, as it leads to asphyxia. 

Central facial paralysis is characterized by paralysis of 
the nose, lips, cheeks, ears, and eyes. There are marked 
symptoms of ptosis affecting both eyes. It is impossible to 
open the eye on account of the paralysis of the sphincter 
muscle. The muscles of the ear become paralyzed, causing 
the ear to droop and point forward. 



The Practice of Veterinary Surgery 39 

Prognosis — The prognosis of unilateral peripheral par- 
alysis is the most favorable, as recovery takes place in from 
two to four weeks. 

The prognosis of bilateral peripheral paralysis is not 
favorable, because it frequently leads to asphyxia. 

The prognosis of central facial paralysis is quite unfavor- 
able, and as a rule is an incurable condition. 

Treatment — The treatment of peripheral facial paralysis 
consists in massage and irritating liniments applied over the 
afifected parts. Internally, give preparations of iron, arsenic 
or iodine. The subcutaneous injections of strychnine over 
the affected area has been followed with good results. In 
cases of dyspnoea, perform tracheotomy. 

The treatment of central facial paralysis is useless. 

Paralysis of the Trigeminal 

Paralysis of the trigeminal nerve may be either peripheral 
or central. The lesion or irritation may affect the nerve 
endings, nerve trunk, or the center in the brain. This disease 
occurs mostly in dogs. 

Cause — This disease may be due to external injuries, but 
as a rule this condition does not occur primarily but is seen 
as a symptom in rabies and brain diseases, in which case it 
is a central paralysis. In rabies a paralysis of the lower jaw 
is an invariable symptom. It may also appear in dog dis- 
temper, abscess formation, hemorrhage, or the formation of 
a tumefaction in the cranial cavity. 

Peripheral paralysis of the trigeminal does not occur 
frequently, but when it does it is due to traumatisms and 
other external injuries. 

Symptoms — Trigeminal facial paralysis appears clinically 
as a motor paralysis, and is characterized by a dropping of 
the lower jaw, in which the animal is unable to close the 



40 The Practice of Veterinary Surgery 

mouth. The mouth can be closed very easily by the hand. 
This is a diagnostic sym.ptom and differentiates it from 
luxation of the mandible. Along with the dropping of the 
jaw, there is difficulty in prehension and chewing, and in 
marked cases this is impossible later on. After this condition 
has existed for some time there is a marked atrophic condition 
of the massetic muscles. 

Prognosis — As a whole the prognosis is unfavorable, 
while mild cases recover. When this disease follows dis- 
temper it is prolonged, but where it occurs as a symptom of 
rabies it is of very short duration. 

Treatment — This consists in the use of iron, arsenic or 
strychnine preparations internally. Externally, massage, irri- 
tating liniments, etc., should be used. 

Trismus 

Trismus is a condition in which there is a spasmodic con- 
traction of the muscles of mastication. This condition never 
appears primarily, but as a symptom of some other disease. 
It is usually seen in tetanus and strychnine poisoning. 

It never becomes necessary to treat this condition, as it 
disappears with the disease of which it is a symptom. 

DISEASES OF THE NASAL CAVITIES AND SINUSES 
Chronic Nasal Catarrh 

A unilateral chronic nasal catarrh is the only form of 
nasal catarrh that is of any importance. This condition prac- 
tically never occurs primarily, but is seen as a symptom of 
some other disease. 

Cause — The conditions that chronic nasal catarrh are 
secondary to, are very difficult to diagnose, but may be one 



The Practice of Veterinary Surgery 41 

or more of the following : Glanders, necrosis of the turbinated 
bones, new formations in the nasal cavities, chronic inflam- 
mation of the mucous membrane of the nasal cavities or of 
the sinuses, diseased teeth or fractures. To make a positive 
diagnosis, the nasal discharge should be carefully examined, 
and the nasal cavities and sinuses inspected and palpated. 
If glanders is suspected, a male kitten or guinea pig should 
be experimentally inoculated with the nasal discharge. If 
the discharge contained glanders bacilli, the inoculated animal 
will show marked orchitis in a few days. 

Treatment — The treatment of chronic nasal catarrh de- 
pends upon the cause. If the cause is empyema of the sinuses 
or an inflammation of the mucous membrane of the sinuses, 
the frontal and maxillary sinuses should be trephined as 
follows : — 

Make an opening into the frontal sinus with a trephine, 
half way between the orbit and median line, about one-half 
inch above the inner canthus of the eye. Then trephine the 
maxillary sinus one inch up and one inch back from the 
point of the zygomatic crest. With a chisel or punch connect 
the two sinuses and at the lowest point of the maxillary sinus 
break into the nasal cavity to insure perfect drainage. This 
should be followed by antiseptic irrigation. 

If this condition is a symptom of glanders, the animal 
should be destroyed, and the carcass burned. 

If due to foreign bodies, remove the foreign bodies as 
soon as possible. If due to diseased teeth, remove the teeth. 

Necrosis of the Turbinated Bones 

In horses a chronic nasal catarrh is frequently accom- 
panied or caused by necrosis of the turbinated bones. This 
consists in a suppurative or necrotic inflammation. If it is 
primarily suppurative in character, it eventually becomes 
necrotic. 



42 The Practice of Veterinary Surgery 

Cause — The most common cause is an irritation caused 
by an acute nasal catarrh, foreign bodies, etc. 

Symptoms — The symptoms present themselves by a 
chronic unilateral suppurative nasal discharge. This dis- 
charge is quite copious, and after a time becomes necrotic 
and very foul smelling. The submaxillary lymph glands are 
swollen, and in some cases so swollen that they are primarily 
visible. The inflammatory process frequently spreads to the 
septum nasi, in which case there is unilateral dyspnoea 
present. 

Treatment — If it is due to necrosis of the turbinated 
bones, the treatment consists in trephining into the nasal 
sinus about two inches below the inner canthus of the eye, 
on the ridge of the nose. This sinus is narrow and shallow. 
It is best to use a half inch trephine and make the opening 
immediately to one side of the median line. Then break down 
into the nasal cavity with the finger or some blunt object, 
remove the necrotic portions if possible, and irrigate with 
some astringent antiseptic. 

New Formations in the Nasal Cavity 

In practice new formations in the nasal cavity are very 
frequently met with. The most common new formations 
are nasal polyps. These are soft, spongy growths, more or 
less movable, and attached to the nasal mucous membrane by 
a small neck. 

Treatment — The treatment of these consists in removal 
by an ecrasure, a curette or scissors. In some cases it becomes 
necessary to trephine over the growth, or split the nostril 
and remove it, although most cases, especially those that are 
low down, can be removed from the nostril. 

There may be a hyperplasia of the mucous glands, causing 
the formation of numerous small cysts, which are sometimes 
called adenomatous polyps. 



The Practice of Veterinary Surgery 43 

The vascular portion of the mucous membrane may 
become infected, causing a unilateral, mucopurulent, or hem- 
orrhagic nasal discharge. The submaxillary lymph glands 
become involved and there is more or less dyspnoea present. 
On palpation this will be felt as a soft, smooth, easily hem- 
orrhagic ulcerating surface. 

Treatment — The treatment of these last-mentioned con- 
ditions is practically useless. 

Sarcomas and carcinomas in the nasal cavities are gen- 
erally secondary from the sinuses or mouth cavity, or they 
may be metastatic in origin. These tumors as a rule are 
firm in consistency, easily hemorrhagic writh a tendency to 
involve the periosteum and break down and suppurate. 
Carcinomas have a tendency to involve the intermaxillary 
lymph glands. 

Treatment — There is no satisfactory treatment for either 
of these conditions, on account of the tendency they have to 
recur, and the fact that they are generally secondary growths. 

Foreign Bodies in the Nasal Cavity 

The most common foreign bodies found in the nasal 
cavities of the horse are food stuffs, teeth, broken bones, 
splinters, sponges and tampons. These do not give rise to 
any symptoms until they have been present for some time. 
Then they give rise to a suppurative nasal discharge, which 
is very offensive. In some cases the discharge seems to be 
very hemorrhagic. 

In sheep and dogs, parasites are the most common foreign 
bodies found in the nasal cavity. 

Fracture of the Nasal Bones 

Fracture of the nasal bones is a condition which is most 
frequently seen in the horse as the result of an injury. These 
fractures as a rule are simple, but may be compound. 



44 The Practice of Veterinary Surgery 

■ Symptoms — The symptoms consist in a visible defect or 
deformity in the region of the injury, epistaxis, nasal dis- 
charge, dyspnoea and emphysema. If a pointed object caused 
the fracture, there will be an abnormal communication with 
the nasal cavity at this point. These cases frequently lead 
to stenosis of the nasal cavity, necrosis of the turbinated 
bones, and in rare cases to the formation of a fistula. 

Treatment — The treatment consists in removing the 
splintets, pieces of bone, trephining if necessary to remove 
the splinters, followed by antiseptic irrigation. In severe 
cases of dyspnoea tracheotomy should be performed. 

DISEASES OF THE SINUSES 

Hydrops 

Hydrops of the sinuses is a condition in which they be- 
come filled with a sero mucous, odorless fluid. 

Forms — In the horse and ox there are two forms of this 
condition ; these are true or retentious hydrops and false or 
pseudo hydrops. 

True or retentions hydrops consists in a collection of 
catarrhal secretion as the result of the closing of the com- 
munication between the sinuses and nasal cavity, preventing 
the escape of the fluid. Pseudo or false hydrops consists in 
a congenital mucous cyst in the maxillary sinus. 

Symptoms — Both of these conditions present the same 
symptoms clinically. There is a marked enlargement in the 
region affected, causing the face to appear bulged in the 
region of the sinuses. After this condition has existed for 
some time the bone becomes softened, and this permits 
bulging of the outer plate of bone. Palpation over the afifected 
area reveals the softened consistency of the bone, while on 
percussion a tympanitic tone is heard. There is a sero mucous, 



The Practice of Veterinary Surgery 45 

or muco purulent discharge from the nose, but this is not a 
constant symptom, for in some cases it may not be present. 
Inflammation of the submaxillary lymphatics may also fail to 
be a constant symptom, although it is present in most cases. 
In congenital hydrops there is often found degeneration of 
the nasal, maxillary and turbinated bones. 

Treatment — The treatment consists in trephining the 
maxillary sinus one inch up and one inch back from the point 
of the zygomatic ridge, evacuate the sinus and irrigate with 
astringent "antiseptics. It may be necessary to make an 
opening into the nasal cavity to insure perfect drainage. 

Empyema 

Empyema is a condition in which the sinuses become 
infected with pus cocci, causing them to be filled with pus. 
This condition is quite common in the horse and is of great 
surgical importance. 

Cause — The most common causes of empyema are a sup- 
purative or catarrhal condition of the nasal mucous membrane 
with the process spreading to the sinuses, compound fractures, 
foreign bodies in the sinuses, diseased teeth, alveolar periostitis 
or ulcerating tumors in the sinuses. The most common cause, 
however, is diseased teeth. 

Symptoms — The most prominent symptom is a unilateral 
suppurative nasal discharge, which is discolored and has a 
very offensive odor. This discharge seems to be more profuse 
when the head is lowered. The intermaxillary and submaxil- 
lary lymphatics are swollen and painful to the touch. In the 
region of the affected sinus there is usually an enlargement. 
On percussion the affected region is painful and tympanitic. 
It may occur that this condition will be associated with a com- 
plicated fracture, suppurative periostitis or fistula in the region 
of the sinuses. 



46 The Practice of Veterinary Surgery 

Prognosis — The prognosis as a whole is favorable, especi- 
ally if the sinus is evacuated before the bone becomes in- 
volved. 

Treatment — The treatment consists of evacuating the 
affected sinus as soon as possible This is accomplished by- 
trephining. As a rule both the frontal and maxillary sinuses 
are affected, therefore it becomes necessary to open both 
sinuses, connecting them with a free opening, followed by 
antiseptic irrigation. An opening from the lowest part of the 
maxillary sinus into the nasal cavity should be made to insure 
perfect drainage. The frontal sinus should be trephined about 
one-half inch above the inner canthus of the eye, and one inch 
from the medium line, while the maxillary sinus should be 
trephined one inch up and one inch in back from the point of 
the zygomatic crest. 

These trephine openings should be made at least one inch 
in diameter and the opening should be kept open as long as 
possible to insure perfect drainage. 

New Formations of the Sinuses. 

New formations in the sinuses are not at all uncommon. 
As a rule they are not primary infections but appear 
secondarily. Mucous cysts, sarcomas, carcinomas and acti- 
nomycomas appear most commonly. 

Carcinomas generally arise from the epithelium of the 
gums or mouth, while sarcomas arise from the mucous mem- 
brane of the sinus or the periosteum. 

Symptoms — New formations in the sinuses will generally 
give rise to visible enlargements, although this is not constant. 
The submaxillary lymph glands become swollen and painful. 
Later on there is a nasal discharge mixed with blood, which is 
very offensive, somewhat resembling decomposition. 

Sarcomas and carcinomas give rise to distintregation of 
the bone. They spread and involve, not only the sinuses but 



The Practice of Veterinary Surgery 47 

the roof of the mouth and the nasal cavity. These tumors 
seem to replace the bone. This leads to a falling out of the 
upper molars or they may be extracted with the fingers. The 
fingers can be passed into the sinuses from the mouth by 
passing them alongside of the teeth. When this disease has 
progressed for some time, large, soft, spongy growths may 
be felt in the mouth cavity. 

Prognosis — The prognosis in these cases is unfavorable. 

Treatment — Treatment is of no practical value, as these 
cases are difficult to diagnose, until the diseased process has 
invaded the nostril and mouth, at which time treatment is 
useless. The majority of these cases lead to death. 

If the condition can be diagnosed, or if it is met with 
while trephining for some other condition, the treatment con- 
sists in total extirpation with curettement, followed by anti- 
septic irrigation. It may be necessary to have a very large 
trephine opening to successfully remove the tumor. 

Diseases of the Teeth. 

Rough, sharp and irregular table surfaces on the teeth 
appear very frequently and are produced by some abnormality 
in the lower jaw itself or in the placing of the lower jaw. This 
interferes with the act of mastication so that it cannot be 
properly executed. The most common defect is an abnormal 
narrowness of the lower jaw. This prevents the entire table 
surface from coming into wear, and this leads to the formation 
of sharp points on the outside of the upper teeth and the 
inside of the lower teeth. These sharp and rough edges cut 
the tongue and the inside of the cheeks, and as the result of 
chronic irritation, ulceration results. This hinders mastication 
and leads to digestive disturbances. On examining the teeth 
particles of food are found between the teeth and cheeks. 



48 The Practice of Veterinary Surgery 

Treatment — The treatment consists in removing these 
sharp edges and points with a float. The table surface proper 
sihould never be floated in this condition, but the edges only. 
Great care must be taken that -too much of the tooth is not 
removed, for in most cases more harm than good will be done 
if the teeth are not properly floated. 

This treatment does not hold good in tongue lawling due 
to the teeth. If tongue lawling is due to the teeth, it is usually 
an abnormal narrowness of the lower jaw with sharp points. 
In these cases there does not seem to be the proper amount of 
room in the closed mouth for the tongue. It is good practice 
to round the inner edges of the lower teeth in these cases, and 
make them as smooth as possible. It may become necessary 
to remove the edges with closed cutters. Under ordinary 
circumstances tongue lawlers will yield to this line of treat- 
ment. 

Shear Mouth. 

Shear mouth consists in an abnormally slanting position 
of the table surfaces of the molars. The upper teeth are not 
above the lower teeth as they should be, but are to one side 
of them, so that the table surfaces of the teeth are nearly side 
by side instead of meeting end to end. 

As a rule this condition is unilateral. This causes the 
animal to chew on the side that is not affected, avoiding the 
afifected side of the mouth completely. As a result of this 
the teeth which are not brought into wear by mastication 
become afifected with sharp points, caries dentium, alveolar 
periostitis and unilateral arthritis. These sharp points and 
caries dentium lead to stomatitis. 

Bilateral shear mouth is generally brought about by an 
abnormal narrowness of the lower jaw, so that the movement 
of mastication cannot be properly performed. Only a small 
portion of the table surface comes into wear, while the re- 
mainder continues to grow down, forming rough sharp edges. 



The Practice of Veterinary Surgery 49 

Partial shear mouth is a condition in which a few teeth 
are affected. It is brought about by the opposing teeth being 
of extreme hardness ,causing great wearing, or the opposing 
teeth are improperly placed. 

The disturbances that shear mouth gives rise to depend 
largely upon the severity of the case. In very mild cases, that 
is partial step mouth, there is practically no disturbance of 
mastication. 

In more severe cases the act of mastication cannot be 
properly performed, causing the animal to eat slowly. Marked 
cases lead to severe disturbances of mastication, inanition and 
death. 

Treatment — In partial or unilateral shear mouth the treat- 
ment consists in cutting off the irregular edges and making 
the mouth as smooth as possible. As much of the tooth should 
be cut away as will be necessary to prevent injuries to the 
cheeks and tongue. Very severe cases of unilateral shear 
mouth as well as bilateral shear mouth are incurable and treat- 
ment is useless. The condition has a tendency to grow worse 
ending in death. 

Step Mouth. 

Step mouth consists of an irregular length of the individual 
teeth, causing great irregularity in the table surfaces of the 
individual teeth. 

Cause — The most probable cause is unevenness of hard- 
ness of the individual teeth or an irregularity of the opposing 
set of teeth. 

Symptoms — This condition leads to difficulty in mastica- 
tion, causing the food to be improperly chewed. This in turn 
leads to disturbances of mastication. 

Treatment — The treatment consists in cutting off the long 
teeth and making the table surfaces of the teeth as regular as 
possible. 



50 The Practice of Veterinary Surgery 

DISEASES OF THE INDIVIDUAL TEETH. 

Caries. 

Caries is a continual dry disintegration of the entire tooth 
substance, including the enamel, dentine and cement. 

As a rule caries begins on the table surface, while in some 
instances the sides of the tooth l)ecome afifected first. This 
latter is seen most particularly in the dog, while the first 
mentioned condition is seen in the horse. This process soon 
leads to the formation of cavities. These cavities seem to 
follow the infundibuli of the teeth. 

Cause — The exact cause of caries is undoubtedly some 
form of bacteria, although they have not been definitely isolated 
as yet. Such predisposing causes as chilling, soft teeth, 
mechanical injuries, bad food and rickets are important factors 
in bringing on the disease. 

Symptoms — Teeth that are affected with caries are rough, 
contain cavities and are discolored brown. These teeth have 
a very offensive odor and have a tendency to split. This dis- 
ease is more or less painful and as a result of this there is 
interference with mastication and stomatitis. After caries has 
existed for some time it may become associated with fistula 
and alveolar periostitis. 

Prognosis — If properly treated' the prognosis is favorable. 

Treatment — The treatment consists in removing the dis- 
eased tooth as soon as detected. This should be done with 
extractors if possible. Trephining with repulsion should not 
be performed until extraction is fo-und impossible. 

Alveolar Periostitis. 

Alveolar periostitis consists in an inflammation of the 
root of the tooth, the alveolar periosteum or the para dental 



The Practice of Veterinary Surgery 51 

membrane. In most instances all three of these tissues be- 
come affected. This inflammation is either suppurative, ossi- 
fying or actinomycotic in nature. 

An ossifying alveolar periostitis is an aseptic inflamma- 
tion and leads only to the adhesion of the tooth to the sur- 
rounding bone. This form is of great practical importance on 
account of the fact that it often renders extraction impossible, ' 
without removing a portion of the surrounding tissues. 

Suppurative alveolar periostitis is seen most commonly 
in the hofse and is the most important form from a surgical 
standpoint, while actinomycotic alveolar periostitis is seen 
mainly in the ox. 

Cause — The most common cause of suppurative alveolar 
periostitis in the horse is caries. The infection is carried to 
the periosteum through the matrix of the tooth or along side 
of the tooth, between it and the gum. It may follow splitting 
of the teeth, compound fractures of the jaw, and injury to an 
adjoining tooth in extraction. It is held by some authorities 
that this disease is due to a specific infection. 

This condition may be brought about in the dog by ulcera- 
tion with a very fetid odor from the mouth. In some instances 
the saliva is streaked with pus and very offensive. There are 
also symptoms of stomatitis. In severe cases the affected 
teeth become loosened and have a tendency to fall out. The 
gums surrounding these teeth are badly inflamed. There is 
also a suppurative ill-smelling nasal discharge from the nostril 
on the affected side, swelling of the submaxillary lymphatics 
and in extreme cases necrosis of the bone in the region of the 
affected teeth. ^ 

Prognosis — The prognosis is favorable in ordinary cases 
if properly treated. 

Treatment — The treatment consists in removing the 
affected teeth as soon as detected. It may become necessary 



52 The Practice of Veterinary Surgery 

to trephine and repel the teeth ; however, extraction is usually 
possible. If the sinuses are affected, give drainage into the 
nasal cavity and irrigate with astringent antiseptics. 

Tooth Fistula. 

Tooth fistula is a condition in which there is a fistulous 
formation through the bone surrounding the tooth, as a result 
of some diseased process involving the tooth. From a clinical 
standpoint two forms of tooth fistula are diagnosable, the first 
is true tooth fistula and the second false tooth fistula. 

Cause — True tooth fistula usually results from a suppura- 
tive process of long standing, which surrounds the tooth. 
This is then carried to the bone with a resulting necrosis of 
the bone and the discharging of pus forming a fistulous canal. 
This process is usually brought about by caries or suppurative 
alveolar periostitis. It may occur from a compound fracture 
involving the tooth, but this is very rare in practice. 

Symptoms — In true tooth fistula the symptoms appear 
somewhat like a combination of caries and alveolar periostitis, 
but in either case there is accompanying this a fistula. This 
condition appears mostly in older horses and dogs. The most 
common seat for the fistulous opening is on the lower jaw in 
the horse, in the region of the premolars, and on the face in 
dogs in the region of the inner canthus of the eye. 

The fistulous opening is small and appears somewhat 
constricted. By passing a probe, a canal can be detected 
leading to the root of the tooth. This canal discharges more 
or less of a very offensive exudate. As a rule, by exploring the 
mouth, a positive diagnosis can be made. 

Prognosis — The prognosis of true tooth fistula should 
be made with care, while as a whole the prognosis is favorable. 



The Practice of Veterinary Surgery 53 

Course — The course of this disease is long- and drawn 
out, especially if it becomes complicated with empyema of 
the sinuses or necrosis of the turbinated bones. 

Treatment — The treatment consists in removing the 
affected teeth, with curetting or cauterizing the fistulous canal. 
This should be followed by antiseptic irrigation. It is essen- 
tial to provide good drainage for the canal. Ordinarily the 
tooth may be extracted, but in some cases it becomes neces- 
sary to trephine and repel the tooth. Subcutaneous injections 
of bacterins seems to aid markedly in the treatment of these 
cases. 

False Tooth Fistula. 

Cause — The cause of false tooth fistula is compound frac- 
tures, contusions and other mechanical injuries. It is seen to 
occur in the region of the premolars of the mandible as the 
results of kicks. This form of fistula has no connection with 
the teeth whatsoever. 

Symptoms — The symptoms of false tooth fistula are quite 
similar to those of true tooth fistula, except that there are no 
teeth involved. The fistulous canal seems to be very super- 
ficial and it terminates in a blind ending. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in curetting or cauter- 
izing the canal, providing drainage and antiseptic irrigation. 
Basterins and antistreptococcic serum may be used to advan- 
tage in these cases. 

Extracting Teeth. 

In the extraction of teeth there are some things that are 
very necessary to observe to obtain the desired results. Before 
proceeding to extract a tooth, make a careful diagnosis and 
determine exactly which tooth is to be extracted. Then care- 



54 The Practice of Veterinary Surgery 

fully locate the diseased tooth so the extraction can be applied 
to it without injury to the neighboring teeth. After fully 
determining this, choose the proper forceps for the tooth and 
see that the forceps are properly fitted before an attempt is 
made at extraction. Then the tooth should be loosened by 
lateral movements of the forcep. This must be carefully 
executed because the crown of the tooth is easily broken. 
After the tooth has been loosened, use a fulcrum and pry the 
tooth out. 

In cases where the crown of the tooth is broken or decayed 
it is almost impossible to extract the tooth. In these cases 
trephining with repulsion must be resorted to. 

Fracture of the Lower Jaw. 

Fracture of the lower jaw is usually the result of mechan- 
ical injuries, such as being kicked or bitten, falling, stumbling 
and striking the jaw, by forcibly opening the mouth with a 
speculum, the use of a severe curb bit, or in the young by 
giving assistance during birth. A fracture of the mandible 
has been known to occur by the animal striking the chin with 
the knee. 

These fractures may occur at any point and may be a 
square fracture, a median fracture of the body, a fracture of 
the ramus, a fracture of the alveolus, exposing the teeth, or a 
fracture of the neck near the articulation. 

Symptoms — The symptoms of fracture of the mandible 
vary greatly, but there is usually anorexia or difficult mastica- 
tion, and a painful swelling in the region of the fracture. This 
swelling may or may not crepitate. 

Prognosis — The prognosis is always favorable in simple 
fractures, but unfavorable in compound fractures and frac- 
tures exposing the alveolus of the teeth. 

Treatment — The treatment of these cases as a whole is 
very unsatisfactory, because it is impossible to apply splints 



The Practice of Veterinary Surgery 55 

or a plaster bandage. Simple cases will generally recover if 
left alone. The treatment of compound fractures should con- 
sist in removing the splinters of bone, giving drainage followed 
by antiseptic irrigation. 

Actinomycosis in the Region of the Lower Jaw. 

Actinomycosis appears in the region of the lower jaw as a 
specific wound infectious disease. It may also occur in the 
region of the upper jaw, but only rarely. This condition is 
seen mainly in the ox, and the premolars are the most common 
point of infection. 

Cause — The specific cause is the rayed fungus actinomy- 
cosis. This becomes wedged between the teeth aling with food 
particles and from here it enters the gums and finally the 
alveolar cavity of the teeth. The infection may not involve 
the teeth nor the bone, but may appear as a localized afifection 
either in the skin or subcutaneously. In these cases it is 
usually caused from skin infection. 

After the rayed fungus becomes lodged in the gums and 
alveolar cavities it gives rise to a constant set of lesions, later 
on forming granulomatous tumefactions. This is followed by 
disintegration of the tooth substance. Finally the infection 
is spread to the bone surrounding the teeth and periosteum, 
causing ossifying periostitis, granular or rarifying ostitis and 
eventually osteoporosis. 

Symptoms — The main symptom is a cold, painless swell- 
ing or tumefaction. The skin is immovable over these tume- 
factions. After some time these tumefactions degenerate, in 
the center, break down and discharge, forming fistulous canals. 
These fistulous canals are very hemorrhagic and discharge a 
thin yellowish exudate, containing sulphur, yellow granules 
somewhat like coarse sand. Mastication may or may not be 
interfered with, depending upon the severity of the lesion. If 
the lesion is extensive it may lead to marked emaciation. 



56 The Practice of Veterinary Surgery 

Examination of the mouth cavity reveals that the teeth 
in the affected region become loosened, and it is possible to 
extract them with the fingers in most instances. There is a 
very offensive odor from the mouth. There are small fungoid 
growths on the gums and the submaxillary lymph glands are 
involved. 

Prognosis — The prognosis is unfavorable. 

Course — The course is chronic. 

Treatment — The treatment of these cases in which the 
bone and teeth are involved is very unsatisfactory and these 
cases are practically incurable. The progress of the disease 
may be checked but the chronic swellings remain permanently. 
Potassium iodine should be given daily in one-half ounce 
doses, until symptoms of iodism appear. Tincture of iodine 
may be applied over the tumefaction and injected into the 
fistulous tracts. The tracts may also be sloughed with 
escharotic paste or arsenic paste, but this is of no practical 
value. If the teeth are loose, extraction is indicated. 

If the tumefaction is in the skin and subcutaneous tissues, 
the proper method of treatment is enucleation followed by 
antiseptic irrigation. In some cases it may be advisable to use 
escharotics in the fistulous canals, producing as much slough- 
ing as possible. The best agents for this are arsenous acid 
or zinc chloride. These should be mixed with enough water 
and gum arabic to form a paste, then mix with waste or wick- 
ing, pack the canals and stitch. In about one week sloughing 
will be complete. 

DISEASES OF THE TONGUE. 

Acute Glossitis. 

Glossitis is an inflammation of the tongue. Acute glossitis 
is either a superficial swelling of the mucous membrane, or the 



The Practice of Veterinary Surgery 57 

inflammatory condition involves the deeper structures and is 
parenchymatous or phlegmonous in character. 

Cause— Acute glossitis may appear as a primary disease 
from injuries, burns, cauterization, etc., or as a symptom of an 
infectious or contagious disease, as foot and mouth disease, 
anthrax, or malignant oedema. Phlegmonous glossitis is of 
the greatest clinical importance, because it frequently appears 
in the horse as the result of injuries, cauterization (chloral 
pills), sharp teeth, or rough manipulation while floating" the 
teeth. 

Symptoms — The tongue becomes greatly swollen, dis- 
colored blue or bluish black, and the surface of the tongue is 
rough and fissured. Along with this there is salivation, diffi- 
cult deglutition and mastication, and more or less pharyngitis. 
In very severe cases especially from cauterization the mucous 
membrane of the tongue becomes necrotic. In the ox there 
may be a circumscribed necrosis of the tongue, which in some 
cases becomes completely perforating. 

Prognosis— The prognosis of acute glossitis which appears 
primarily as a whole is goixl. Cases due to cauterization are 
more unfavorable, while in S3'mptomatic glossitis it disappears 
with the disease of which it is a symptom. 

Course — The course of this condition is acute. 

Treatment — The treatment consists in warm antiseptic 
irrigation of boric acid, sodium bicarbonate, or potassium 
permanganate. These preparations will be found very useful 
in checking the inflammatory process. Keep a bucket of fresh 
water .before the horse continually containing potassium 
chlorate. Any necrotic areas should be excised. If this dis- 
ease leads to dyspnoea, perform tracheotomy. 



58 The Practice of Veterinary Surgery 

ACTINOMYCOSIS OF THE TONGUE. 

Wooden Tongue. 

So-called wooden tongue or actinomycosis of the tongue 
appears as a wound infectious disease. It is seen to occur most 
commonly in the ox, but has been known to occur in the horse. 

Cause — This condition is due to the entrance of the rayed 
fungus into the substance of the tongue, giving rise to an 
interstitial glossitis. 

Symptoms — This process begins by the formation of small 
tumefactions, appearing somewhat like erosions or ulcers on 
the sides and top of the tongue. The infection enters the 
deeper structures of the tongue and then there arises numer- 
ous yellow granulating areas about the size and depth of a 
hazel nut. On section these are found to contain sulphur 
yellow granules and a caseous mass. This disease gives rise 
to the formation of new connective tissue, causing the tongue 
to become large and firm. As the result of this new formed 
connective tissue contracting, the tongue becomes contorted 
and drawn into various shapes. This also causes an atrophy 
of the muscles of the tongue, so that on section the musculature 
is almost absent. The submaxillary lymph glands are swollen, 
painful and frequently suppurate. 

As the result of this enlarging and thickening of the 
tongue, there are disturbances in mastication and deglutition. 
In severe cases there is profuse salivation with a continual 
loss of flesh. 

Prognosis — The prognosis in mild cases is favorable, while 
in severe cases it is unfavorable. 

Course — The course is chronic. 

Treatment — The treatment consists in giving potassium 
iodide internally in one-half ounce doses daily, until symptoms 



The Practice of Veterinary Surgery 59 

of iodism appear. The tongue should be incised. These in- 
cisions should be made very deep into the substance of the 
tongue, followed by the free use of tincture of iodine. Paren- 
chymatous injections of Lugol's solution are also very satis- 
factory. 

Fracture of the Hyoid Bone. 

Fracture of the hyoid bone is a condition which is not 
met with frequently in practice. 

Cause — This condition is seen to occur most commonly 
as the result of drawing the tongue from the mouth roughly 
or with great force. It may occur as the result of necrosis of 
the hyoid bone from glanders. 

Symptoms — The main symptoms are those of paralysis 
of the tongue. The tongue hangs from the mouth, and the 
animal is unable to use it. There is profuse salivation, difficult 
mastication and deglutition, swelling in the region of the 
pharynx, and in some cases the saliva is admixed with blood. 

Prognosis — The prognosis is unfavorable. 

Treatment — The treatment is w^orthless, because these 
cases usually lead to severe phlegmonous pharyngitis with 
asphyxia. 

Paralysis of the Tongue. 

Paralysis of the tongue appears in two forms, these are 
neurogenous and myogenous. A myogenous paralysis is 
usually due to external causes while a neurogenous paralysis 
is due to an injury or irritation of the hypoglossal nerve. This 
paralysis may be unilateral, bilateral, central or peripheral. 

A central paralysis of the tongue may follow or appear as 
a symptom of an infectious or contagious disease, or a brain 
disease, or from a new formation in the cranial cavity or along 
the course of the nerve. 



^o The Practice of Veterinary Surgery 

Peripheral lingual paralysis is most commonly brought 
about by various traumatisms or inflammatory conditions. 

Symptoms — The symptoms of unilateral myogenous 
paralysis consist in the tongue being drawn to the affected 
side. If the tongue protrudes from the mouth it is from the 
side. This form of paralysis renders mastication and degluti- 
tion difficult. 

In bilateral myogenous paralysis of the tongue, the tongue 
protrudes from the mouth and the animal has very little con- 
trol over it. Mastication and deglutition are severely inter- 
fered with. If this paralysis appears in a mild form and be- 
comes chronic, atrophy of the tongue follows. 

Prognosis — As a whole the prognosis is good. 

Treatment — The treatment consists in subcutaneous in- 
jections of strychnine or veratrin, or the use of nux vomica 
internally along with rhus tox. 

DISEASES OF THE PHARYNX. 

Pharyngitis. 

From a surgical standpoint, traumatic and phlegmonous 
pharyngitis are to be considered, for these diseases are fre- 
quently associated with retro-pharyngeal and sub-parotid 
abscesses in the lymph glands. 

The surgical treatment of these conditions consists in 
opening the abscesses and in cases of dyspnoea perform 
tracheotomy. In opening these abscesses make the incision 
through the skin only, and with the finger or a blunt instru- 
ment burrow into the abscess and evacuate its contents. This 
should be followed by antiseptic irrigation. 

Tracheotomy should be performed as follows : The most 
satisfactory seat for the operation is in the upper third of the 



The Practice of Veterinary Surgery 6i 

trachea, at a point where the trachea is subcutaneous. Shave 
and disinfect the area, make an incision through the skin about 
one and one-half inches long parallel with the trachea. Then 
incise the annular ligament to about one-third of its circum- 
ference. This will allow the tube to be placed between two 
rings of the trachea. A small self-retaining tube should 
always be used, as they are safe. If tracheotomy is performed 
in this manner the wound will heal, leaving behind no visible 
scar. The practice of removing a portion of the cartilage from 
a ring of the trachea is faulty as it is not necessary, and leads 
to serious after effects, as chondritis and parachond'ritis. These 
are serious conditions and frequenth' render the animal value- 
less. The tube should be removed daih^ and cleansed. 

New Formations in the Pharynx, 

Such new formations as actinomycomas, papillomas, cysts 
and tubercular new formations are found in the pharynx. 

Actinomycotic new formations in the pharynx of the ox 
are of clinical importance. 

According to the location these tumefactions are classified 
as anti and post-pharyngeal. 

Symptoms — These tumefactions do not cause any notice- 
able symptoms, except when they become enlarged ; then they 
cause difficulty in deglutition and respiration. 

Prognosis — The prognosis as a whole is favorable. 

Treatment — The chief treatment for actinomycotic tumors 
consists in giving potassium iodine internally in one-half ounce 
doses until symptoms of iodism appear. If possible, these 
tumors may be removed through the mouth, or through an 
incision made in Viborg's triangle. 

In the horse there are frequently found cysts, which are 
soft in consistency, fluctuating, painless and filled with mucous. 
These are usually situated behind the pharynx and lead to 



62 The Practice of Veterinary Surgery 

dyspnoea and difficulty in deglutition. These may be felt easily 
with the hand by using a mouth speculum. 

Treatment — The treatment consists in opening and evacu- 
ating the cysts through the mouth. There is no after treat- 
ment necessary. 

DISEASES OF THE GUTTURAL POUCHES. 

Catarrh of the Guttural Pouches. 

From a surgical standpoint, catarrh of the guttural 
pouches is an important disease. 

Cause — Catarrh of the guttural pouches is usually the 
result of the spreading of a catarrhal condition from the 
larynx or pharynx. It is a secondary disease and does not 
appear as a primary afifection. The spreading of this catarrhal 
inflammation takes place through the Eustachian tubes. In 
some cases this condition is brought on by the entrance of a 
foreign body into the guttural pouch from the outside through 
a perforating wound. This later may cause an abscess, or an 
abscess in the region of the guttural pouches may evacuate 
its contents into the pouches causing empyema. As a rule, 
catarrh of the guttural pouches does not lead to any further 
disturbance, but in some cases may lead to hydrops or the 
formation of concrements. 

Symptoms — The symptoms of catarrh of the guttural 
pouches consist in a unilateral nasal discharge, which is most 
marked when the head is held low. lliere is a soft, doughy 
swelling in the region of the parotid gland. This swelling is 
not painful and the submaxillary lymph glands are involved. 

Prognosis — The prognosis is not always favorable. 

Course — The course is chronic. 

Treatment — The treatment is operative and consists in 
opening the guttural pouch, exacuating the contents, giving 



The Practice of Veterinary Surgery 63 

thorough drainage, followed by irrigation with astringent 
antiseptic washes. This opening should be made in the center 
of Vilorg's triangle, which would be immediately behind the 
angle of the jaw, about three inches below the base of the ear. 
The incision should be made through the skin only with a 
knife, and then with a blunt instrument or the finger break 
into the pouches. It is dangerous to incise into the pouches on 
account of the proximity of large vessels. 

DISEASES OF THE EAR. 

Ulceration of the Ear. 

Ulceration of the concha and the tip of the ear appears 
mostly in dogs. At first this simply consists in a superficial 
ulceration, but on account of the irritation produced, the 
animal scratches, causing the disease to spread and become 
worse. 

Symptoms — On the inner surface of the ear ulcerating 
surfaces can be seen. This leads to a slight discharge, which 
as a rule is not offensive. This discharge is usually suppura- 
tive, but may be bloody from the animal scratching the affected 
part. 

Prognosis — The prognosis is good. 

Treatment — The treatment consists in the use of drying 
agents in the form of dusting powder, as borax, boric acid, 
zinc oxide, etc. In severe cases, the ulcerating surfaces should 
be cauterized with silver nitrate, followed by dusting powders. 

OTITIS EXTERNA. 
Canker. 

Otitis externa, or otorrhea, is a catarrhal or suppurative 
inflammation of the skin in the region of the external auditory 



64 The Practice of Veterinary Surgery 

canal. This condition is seen mostly in long-haired dogs with 
long ears. 

Cause — The most common causes are filth, dirt, and it has 
been known to follow dog distemper. 

Symptoms — The most prominent symptom is a slimy foul 
smelling discharge, which along with filth and dust forms a 
mat or crust just below the ear. This disease seems to be 
painful, for the animal holds the head to one side and con- 
tinually shakes the head. B_y examining the ear, the skin at 
the base of the ear seems to be slightly necrotic and covered 
with the slimy exudate. 

Prognosis — The prognosis as a whole is good. 

Course — The course is chronic. 

Treatment — Before any medicinal agents are applied, 
rcnioxe the filth and the long hair, and thoroughly cleanse 
the parts with soap and water. This is to be followed with 
antiseptic washes or dusting powders. In all probability alco- 
holic solutions of antiseptics will be found most serviceable 
from a practical standpoint, as Balsam of Peru, ten per cent; 
calendula, ten per cent; chinosol, ten per cent; ichthyol, ten 
per cent. Borax and boric acid with iodoform will be found 
the most satisfactory dusting powders. Any medicinal agents 
used must be applied with great regularity, for these cases are 
obstinate and need careful treatment. 

Otitis Media. 

Otitis media consists in an inflammation of the mucous 
membrane lining the middle ear. It is seen most commonly in 
dogs but may occur in any animal. 

Cause — In dogs otitis media is most frequently caused 
from pharyngitis or the spreading of an inflammatory condi- 



The Practice of Veterinary Surgery 65 

tion from the outer part of the ear, and by parasites. In 
horses, a suppurative otitis media may occur from the entrance 
of foreign bodies. The most common symptom is deafness. 
This condition is incurable. 

DISEASES OF THE PAROTID GLAND. 

Salivary Fistula. 

Salivary fistula is a condition in which there is an abnormal 
communication between a salivary gland or duct, with the 
external surface of the body. Clinically, salivary fistula appears 
in two forms. The first is a fistula of the gland and the second 
is a fistula of the duct. 

Cause — The causes of both forms are irritations, injuries, 
and wounds from external sources. 

Symptoms — The symptoms of glandular salivary fistula 
and fistula of the duct are similar. In a glandular fistula the 
opening is in the region of the aflfected gland, while in fistula 
of the duct, Steno's duct is aflfected most commonly, and the 
opening is where the duct passes around the angle of the jaw. 
A salivary fistula is characterized by a small round constricted 
opening, which discharges more or less saliva. The amount 
of saliva discharged varies, but is more profuse during masti- 
cation. 

Prognosis — The prognosis depends upon the cause and 
the length of existence of the fistula. 

Treatment — The most logical treatment consists in de- 
stroying the function of the aflfected gland. This may be 
accomplished by making parenchymatous injections of Lugol's 
solution into the gland. It ma}'^ become necessary to extirpate 
the gland. In fistula of the duct, the opening may be cauter- 
ized and sutured with a purse string suture. However, this 



66 The Practice of Veterinary Surgery 

does not give desired results and sooner or later it becomes 
necessary to destroy the function of the gland. In rare cases 
there may be a dilatation of the duct as the result of fistula. 

Salivary Concrements. 

Salivary concrements are deposits of lime salts of various 
shapes and size, which are found in the ducts of salivary 
glands, or in the glands themselves. In horses, these fre- 
quently become so large that it leads to ectasea of the duct. 

Cause — The supposition is that foreign bodies pass up the 
duct from the mouth, and on these there is precipitated lime 
salts. 

Symptoms — These concrements may be felt as hard firm 
bodies, which are movable any place along the course of the 
duct or in the gland itself. As a rule, they are found in 
Steno's duct where it passes around the angle of the jaw. 
They may occur single or in multiple. 

Treatment — The treatment consists in removing the 
calculus. This consists in incising the duct, removing the 
calculus, and carefully suturing. If the duct is not carefully 
and properly sutured, a fistula will result. The walls of the 
duct should be sutured with catgut. Continuous sutures are 
preferable. Then pack the wound and apply enough sutures 
to retain the packing. After three days, remove the pack and 
allow the wound to heal by second intention. 

Fistula of the Ear. 

An ear fistula consists in a congenital malformation at the 
base of the ear. This condition generally appears in colts. 

Cause — The most common cause is an encysted tooth 
becoming lodged at the base of the ear. In some cases an 
atheromatous cyst is the cause. Sometimes during embryonic 



The Practice of Veterinary Surgery 67 

life there is a bit of tissue misplaced, which later on forms a 
tooth. As a rule, this tooth is similar to a molar. 

Symptoms — At the base of the ear there is a small round, 
constricted, fistulous opening, which discharges a muco- 
purulent exudate. By passing a probe into this fistulous 
canal, the end of the probe will come in contact with a hard 
object. This is the misplaced or encysted tooth. As a rule, 
this canal is short, not being over three or four inches in 
length. 

Prognosis — If properly treated the prognosis is good. 

Treatment — The treatment consists in incising down onto 
the cyst and removing it along with its contents. This should 
be followed with antiseptic irrigation. The fistulous tract 
should be cauterized or curetted, followed by antiseptic irriga- 
tion. 

Fracture of the Skull. 

Fractures of the dififerent bones of the skull are common 
in the domestic animals. These fractures may be simple, 
compound, fissured, splintered, or in a young animal there 
may be an impression in which the position of the bone is 
changed, without any serious injury to the bone itself. 

Cause — The most common cause of this condition is 
accidental mechanical injuries and various traumatisms. 

Symptoms — Locally in the region of the fracture there 
is pain, swelling and crepitation. In a compound fracture 
there is a wound exposing splinters of bone. There may be 
simply an impression or indentation in young animals. If the 
fracture involves the nose or mouth, there will be epistaxis or 
hemorrhage from the mouth. 

Prognosis — The prognosis of simple fractures is always 
favorable, while in compound fractures the prognosis should 
be made with care. 



68 The Practice of Veterinary Surgery 

Treatment — In simple fractures, treatment is not neces- 
sary unless it is an indentation, when it becomes necessary to 
trephine and replace the bone, followed by antiseptic irrigation. 

In compound fractures, great antiseptic precautions are 
necessary. Remove all splinters of bone, followed by antiseptic 
irrigation. 

DISEASES OF THE NECK. 

Wounds. 

Wounds of the neck are very common and usually result 
from biting, collisions, etc. Frequently there is a wound or 
abscess formation from the subcutaneous injection of drugs, 
phlebotomy, tracheotomy and oesophagotomy. As the result 
of these affections there may be various wound infectious 
diseases, as phlegmon, abscess, fistula, and necrosis of the 
skin. Tetanus and malignant oedema may occur, but not 
commonly. Where they do occur, they are usually the result 
of hypodermic injections. The treatment of these wounds is 
the same as all other wounds, viz., drainage and antiseptic 
irrigation. 

Contusions of the musculature of the neck are usually the 
result of collision and accidental injuries and consist in open 
wounds or a hemorrhagic infiltration with the formation of 
hematomas or myositis. As the result of infection there may 
be phlegmon, abscess formation, or the formation of a fistulous 
tract. The most common seat of infection is the mastoido- 
humeralis muscle. 

Symptoms — The symptoms are a circumscribed painful 
swelling, the head is held to one side, and on motion the 
animal shows some lameness. There may be seen large encap- 
sulated abscesses about the middle of the neck, under the 
mastoido-humeralis muscle. These are very similar to those 
seen on the point of the shoulder. Chronic fistula may also 



The Practice of Veterinary Surgery 69 

occur as the result of a circumscribed necrosis of the muscula- 
ture or of the fascia. 

Treatment — The treatment consists in incision and anti- 
septic irrigation. 

Injuries to the vessels are not as common, but may occur 
as a result of injury or from blood letting (phlebotomy). A 
severe injury to the carotid, causing it to be severed, usually 
ends rapidly in death as a result of hemorrhage. Injuries to 
the jugular usually occur as the result of phlebotomy or in- 
travenous injection, or the jugular may be involved in the 
so-called shoulder abscesses and in opening these abscesses 
it may be severed. The jugular may become involved as a 
result of severe phlegmon in the region of the neck. 

Jugular Fistula. 

A common result of injuries to the jugular is the so-called 
jugular fistula. 

Cause — The causes of this are phlebotomy, in which the 
skin and instruments contained some infection, and this was 
carried to the walls of the vein by blunt instruments, or 
making several incisions in the same region in phlebotomy. 
Thrombo-phlebitis, as a result of intravenous injection, may 
also play an important part in the cause of fistula of the 
jugular. 

Symptoms — The symptoms are those of a suppurative 
thrombo-phlebitis and periphlebitis. The symptoms usually be- 
gin with a phlegmon in the region that was incised ; this opens 
and there is discharged a bloody exudate containing some pus. 
The entire vein is swollen, especially in the region of the head. 
Then there is multiple abscess formation along the course of 
the vein. The visible mucous membranes are bluish in color, 
and there are edematous swellings around the head. Later 



70 The Practice of Veterinary Surgery 

on in the course of this disease there will be difficulty in masti- 
cation, with symptoms of necrosis and pyemia. 

Prognosis — The prognosis is unfavorable. 

Treatment — The treatment in the earlier stages consists in 
opening the skin wound, draining and disinfecting. In cases 
of suppurative thrombo-phlebitis, that portion of the vein 
affected must be extirpated. This is done by tying off the 
vein both above and below and removing the necrotic portion, 
and treating the wound antiseptically. 

Goiter. 

The term goiter is used to designate an enlargement of 
the thyroid gland. It may consist in an enlargement of the 
gland itself or in a new formation in the gland. 

Cause — The exact causative factor of goiter is unknown. 
It seems to occur mostly in dogs and colts, but may appear 
in any animal. 

From a pathological standpoint there are the following 
forms of goiter : Parenchymatous, fibrous, vascular and 
malignant. 

Parenchymatous goiter is the most common form seen 
in practice and generally makes its appearance at about the 
lime of birth. It is sometimes spoken of as follicular goiter. 
It consists in a hyperplastic condition of the gland itself, 
resulting in a multiplication of the epithelial cells of the gland 
and usually terminates in colloid or cystic degeneration. In 
these cases the consistency of the gland is soft and somewhat 
dioughy. 

Fibrous goiter consists in an increase of the interfollicular 
connective tissue. This form of goiter is firm, somewhat 
resembling a fibroid tumor. It frequently occurs that this 
form of goiter calcifies or ossifies. 



The Practice of Veterinary Surgery 71 

Malignant goiter designates the formation of some malig- 
nant tumor in the thyroid gland. 

Vascular goiter designates the formation of an aneurism 

or varicose vein in the thyroid gland. 

Prognosis — The prognosis of goiter varies, but as a rule 
is favorable, especially in parenchymatous goiter. 

Treatment — The main treatment consists in the use of 
iodine internally in the form of potassium iodide, and exter- 
nally in tlie form of tincture or ointment applied to the skin 
in the region of the goitre. Lugol's solution may be injected 
into the affected gland in from three to five cubic centimeter 
doses with fine results. This is the most suitable method for 
the treatment of goiter. 

A few cubic centimeters of iodoform ether may also be 
used! in the same manner with like results. 

Fibrous goiter of long standing or malignant goiter must 
be extirpated. In extirpating this gland, great care must be 
taken not to extirpate the entire gland, as this leads to death. 
Either remove entirely the side which seems to be most 
affected or open both sides of the gland and curette or scrape 
the parenchymatous tissue from the capsule, allowing the 
capsule to remain intact ; suture the free edges of the capsule, 
apply iodoform and then suture the skin. This method allows 
enough of the gland to remain to sustain life. In cases where 
one side of the affected gland is to be removed carefully, tie 
off the vessels both above and below the gland, extirpate, fill 
the wound with iodoform and stitch the skin. 

Poll Evil. 

The most common form of tumefaction on the neck of 
the horse is poll evil. 

Cause — The most probable cause is an injury of some 
character which leads to an infection of the bursa with abscess 



72 The Practice of Veterinary Surgery 

formation. However, all cases do not lead to abscess forma- 
tion, as about twenty-five per cent of these cases remain 
aseptic in the form of serous bursitis or hematoma. There 
are two forms of poll evil from a clinical point of view. 

The aseptic form is the result of traumatisms of various 
grades without infection. It consists in a hemorrhagic infil- 
tration of the skin, subcutaneous tissue or the musculature, 
which results in the formation of a hematoma, serous or sero 
fibrinous bursitis. TTiis bursitis may become chronic, in 
which case it leads to the formation of parabursitis and 
eventually forms a hygroma. 

The suppurative form consists in an infection at the time 
of the injury, resulting in the formation of an abscess. This 
may lead to subcutaneous or intermuscular phlegmon, sup- 
purative bursitis and para bursitis, followed by necrosis of 
the fascia and bone. 

Symptoms — The symptoms of both forms at first are 
quite similar and consist in swelling, pain and heat in the 
region affected. In the asceptic form there are no further 
symptoms except that it leads to a chronic swelling. In the 
suppurative form the degenerative process continues, forms 
fistulous canals, which reach the surface and discharge pus. 
The opening of the fistulous canal is round, smooth and con- 
stricted. When fistulous tracts form, the swelling becomes 
hard, firm and less painful. 

Prognosis — The prognosis should be made cautiously, for 
some of the cases do not respond to treatment readily. 

Course — The course is chronic, although there are a few 
cases that seem to disappear spontaneously. 

Treatment — The treatment of the acute aseptic form 
consists in the application of moist heat, massage and stim- 
ulating liniments. This form should never be operated on 
until it has become chronic and hygroma formation has taken 



The Practice of Veterinary Surgery 73 

place. In chronic cases that are aseptic it is always advisable 
to blister well before operating, as in a great many cases 
blistering will cause a resorption of the exudate. 

The treatment of the suppurative form is divided into 
operative and non-operative. The non-operative line of treat- 
ment consists in the use of escharotics to slough the fistulous 
tract, draining, followed by antiseptic irrigation and dusting 
powders. This form of treatment is a great deal slower in 
action, but as a rule is more successful. After cauterizing, 
if the wound does not granulate, swab with equal parts 
tincture of iodine, phenol and glycerine. The most satisfac- 
tory caustic for these cases consists in the use of escharotic 
paste, which consists of four ounces of zinc chloride, one 
ounce of water, one ounce of gum arable, and four ounces of 
powdered blood root. These should be mixed in the order 
given, rolled out into sticks, and inserted intO' the fistulous 
tracts, the same as a probe. In five to eight days sloughing 
is complete and the sloughed tissue may be removed readily. 

The operative form of treatment for the suppurative form 
consists in removal of necrotic areas with draining, followed 
by antiseptic irrigation. The most successful method of 
removing the necrotic areas is Williams' poll evil operation, 
which is performed as follows : Make an incision, after 
shaving and disinfecting, on the top of the neck in the median 
line, about twelve to fourteen inches long, extending from 
the occipital process backward. Then carefully dissect the 
ligamentum nucha from the surrounding structures, split it 
in halves lengthwise and remove one-half at a time. The 
disital end should be severed first, for if the proximal end is 
severed first it will allow the ligamentum nucha to retract 
and then it is not always possible to remove the necrotic 
areas without making a larger skin incision. After the liga- 
mentum nucha is removed curette the bursa, pack the wound 
with antiseptic gauze and suture the skin. After two days 
remove the pack and treat as an open wound. In performing 

6 



74 The Practice of Veterinary Surgery 

this operation all of the inflammatory tissue must be removed 
to insure success ; if any necrotic areas are not removed heal- 
ing will be retarded. If the wound does not have drainage, 
incisions should be made from the lowest point of the wound 
through the side of the neck. 

In the treatment of the suppurative form internal treat- 
ment with indigo, potassium iodide or copper sulphate are 
very advantageous and seem to assist healing. Along with 
this, subcutaneous injections of autogenous bacterins, or 
polyvalent bacterins and intervenous injections of polyvalent 
antistreptococcic serum should be given, for it has been 
proven beyond doubt that they materially assist in the process 
of healing. If possible, autogenous bacterins should be used, 
and if polyvalent bacterins are used several ampules should 
be given at one injection. It is not necessary to give intra- 
venous injections of polyvalent anti&trepticoccic serum more 
often than once per week, and in all probability an injection 
every two to three weeks would give as satisfactory results. 

Fracture of the Cervical Vertebrae. 

Fracture of the cervical vertebrae is a condition that does 
not occur frequently in animals, but when it does occur it is 
seen mainly in horses and dogs. 

Cause — The causes are mostly accidental and traumatic. 
Running horses may fall on the head, the animal may 
run into something, or hang in the halter. In dogs it may 
occur from being run over, bitten or kicked. This usually 
involves the first four cervical vertebrae; about seventy per 
cent of all cases involve either the third or fourth cervical 
vertebrae. 

In making a diagnosis of this condition, a fracture of the 
body must be differentiated from a fracture of one or more 
of the processes. These fractures may be simple, compound 
or fissured. 



The Practice of Veterinary Surgery 75 

Symptoms — The symptoms of fracture of the cervical 
vertebrje are mainly those of torticollis. The head and neck 
will be twisted and drawn in various shapes. The neck is 
held stiff and there is great pain on moving the 'head or neck 
in any direction. Over the fracture there is a firm, painful 
swelling and crepitation. There is usually some dyspnoea, 
and if the body of the vertebras is fractured there are some 
symptoms of spinal meningitis from pressure on the chord. 
In some cases these fractures lead to a severing of the carotid 
and internal hemorrhage, which terminates fatally. It has 
been observed that in some cases a fracture of the cervical 
vertebras does not make itself manifest in the start, but the 
first symptoms are seen only after a few days. The animal 
may be able to work weeks before the symptoms arise. 

Prognosis — The prognosis of fractures of the cervical 
vertebrae is unfavorable. As a rule, if healing does take place 
the neck will be held stiffly. In a great many cases this con- 
dition leads to death. 

Death may be due to one or more of the following: 
Paralysis of the medulla due to pressure on cord, paralysis 
of the vagus due to compression, meningitis and myelitis, 
septicaemia or internal hemorrhage. 

Treatment — The treatment consists in replacing if pos- 
sible and bandaging. This is very hard to accomplish on 
account of the tension of the parts. Probably the most satis- 
factory method is to tie one rope around the neck of the 
animal and another rope around the loins. In this way the 
great tension may be overcome and the fracture replaced. 
After replacing, a board should be placed along one side of 
the neck and the entire neck placed in a cast, with the head 
as high as possible. After casting, tie the animal's head up 
and do not allow any more motion than absolutely necessary. 



76 The Practice of Veterinary Surgery 

DISEASES OF THE LARYNX AND TRACHEA. 

Roaring. 

Roaring" is in all probability the most common surgical 
disease of the larynx. Roaring is characterized by inspira- 
tory dyspnoea. 

Cause — This inspiratory dyspnoea is probably caused by 
a unilateral paralysis of the recurrent nerve which supplies 
the muscles that move the arytenoid cartilages. As a result 
of this paralysis the arytenoid cartilage drops into the lumen 
of the larynx, causing the vocal cord to be stretched and at 
every inspiration the vocal cord on the affected side is 
vibrated. This vibration of the vocal cord gives rise to a 
peculiar sound, which is the most characteristic symptom of 
the disease. As a ruk the left side of the larynx is affected. 

Although the exact causative factor of this disease is 
not positively known, there are certain conditions and factors 
known about it. In some instances it seems to be heredi- 
tary, as it appears commonly in certain families. Thorough- 
bred and standard bred types seem to be affected most 
commonly. Some authorities seem to think that over-exertion, 
causing an increased blood pressure, will give rise to this set 
of symptoms, by pressure on the recurrent nerve, where it 
passes behind the aorta. Roaring frequently follows certain 
infectious and contagious diseases, as laryngitis, contagious 
coryza, influenza, strangles, etc. It has been known to 
occur from a tumor pressing on the recurrent nerve, or as a 
symptom of blood poisoning. 

Symptoms — This disease is characterized by laryngeal 
inspiratory dyspnoea while the horse is in motion. This 
dyspnoea always becomes more aggravated and the sound 
produced is louder when the horse is driven at a rapid pace. 
The sound that is emitted may be anything from whistling 



The Practice of Veterinary Surgery 77 

to bellowing like a bull. As the dyspnoea increases, the sound 
increases, and the inspiratory movements become more 
labored. The nostrils dilate and if the exercise is continued, 
the animal will fall to the ground exhausted, struggling for 
bre'ath. After a few minutes of rest these symptoms will 
entirely disappear. In chronic cases an hypertrophic condi- 
tion of the muscles of the larynx may be felt by manipulation 
of the larynx externally. It is not good practice to attempt 
to diagnose this condition with the animal quiet or in the 
barn, although in marked cases any sudden exertion may 
produce the sound. This can be accomplished by slapping 
the animal on the side when it is least expected. 

Prognosis — The prognosis should be made with caution. 

Course — As a rule the course is chronic. 

Treatment — Internal treatment of these cases has not 
proven to be of practical value, therefore the treatment is 
operative. There are numerous operations for the relief of 
this condition, but the one here given is very simple to per- 
form and has given good results. 

This operation consists in the removal of the vocal cords 
and the mucous membrane from the lateral ventricles of the 
larynx. The animal should be placed in the dorsal recum- 
bent position with the head extended. Then shave and 
disinfect the area over the larynx. Make an incision through 
the skin to the larynx, then incise the larynx, making an 
opening about three inches long. Then by means of retractors 
spread the larynx so the field of operation will be exposed. 
The first step is to remove the vocal cord on both sides. In 
doing this, care must be exercised so that the arytenoid 
cartilages are not incised, for if they are, this may give rise 
to excessive granulations, and the operation will not be a 
success. Then grasp the mucous membrane lining the 
ventricles and carefully dissect it, removing it all. This will 



78 The Practice of Veterinary Surgery 

give rise to a fresh wound and allows the cartilages to become 
attached to the wall of the larynx by means of granulation 
and cicatricial contracture. After healing, the lumen of the 
larynx remains unobstructed and there is no further dyspnoea. 
The after treatment consists in swabbing or spraying the 
larynx with Lugol's solution. 

If the animal shows any symptoms of dyspncea following 
the operation, tracheotomy should be performed immediately. 

New Formations in the Larynx. 

New formations in the larynx are not seen as commonly 
in practice as might be expected. When they do occur they 
are usually found on the mucous membrane and vocal cords. 
They are usually circumscribed tumefactions, but may be in 
the form of chronic thickenings from ulceration. These 
tumors may be actinomycomas, papillomas, lipomas, cysts, 
atheromas, adenomas, sarcomas or carcinomas. In the ox 
there is frequently a tubercular ulceration found on the 
mucous membrane of the larynx. 

Symptoms — These new formations give rise to dyspnoea 
both inspiratory and expiratory, difficulty in deglutitio'n, and 
in some instances they cause marked emaciation. A positive 
diagnosis can only be made by exploratory lar3'ngotomy and 
feeling or seeing the tumefaction. This condition may be 
suspected where a chronic incurable cough exists. 

Prognosis — The prognosis should be guarded. 

Treatment — The treatment consists in placing the animal 
in the dorsal recumbent position, performing laryngotomy 
and removing the tumors or cauterization of the ulcers. 

The after treatmemt consists in spraying the larynx with 
mild astringent antiseptics. 



The Practice of Veterinary Surgery 79 

Stenosis of the Trachea. 

Stenosis of the trachea is a condition in which the lumen 
of the trachea is made smaller either from internal or external 
causes. The following forms of tracheal stenosis are recog- 
nized : Cicatricial, obturation, compression and congenital. 

Cicatricial stenosis is the form which appears most com- 
m.only in the horse. It generally appears from tracheotomy 
being imiproperly performed, in which a tracheal ring was 
incised, but may be caused from an injury fracturing a ring 
of the trachea. Either of these causes lead to the formation 
of a large amount of cicatricial tissue and thickening of the 
cartilage. Sometimes there develops perichondritis and 
chondritis, which also forms an excessive amount of new 
tissue. 

The formation of this new tissue and the thickening of 
the cartilage fills the lumen of the trachea to such an extent 
that eventually dyspnoea develops. This dyspnoeic condition 
frequently becomes so severe that the animal is rendered 
useless. 

An obturation stenosis very rarely appears in horses, but 
may occur from wounds of the trachea from external sources, 
causing excessive granulation, the formation of a tumor, or 
the lodging of a foreign body along the course of the trachea 
or in the lumen of the trachea. 

Congenital stenosis of the trachea appears as a congenital 
defect which is visible, in which the trachea is abnormally 
small or distorted in shape. 

Symptoms — The symptoms of tracheal stenosis are very 
pronounced and consist in both inspiratory and expiratory 
dyspnoea. The respiratory movements are labored and on 
exercise are performed only with difficulty. By auscultation 
stenotic tones may be heard over the region affected. 



8o The Practice of Veterinary Surgery 

Prognosis — The prognosis of these cases is usually un- 
favorable. 

Treatment — If this condition is caused by faulty trache- 
otomy it is not always possible to get results from treatment. 
The treatment consists in incising the trachea and removing 
the obstruction by enucleation or curetting, followed by anti- 
septic irrigation and dusting powders. This condition may 
be eliminated by performing tracheotomy properly and using 
a small permanent trachea tube. 

DISEASES OF THE OESOPHAGUS. 

Choke or Stenosis. 

The term choke is used to designate a condition in which 
there is a foreign body lodged somewhere in the course of 
the oesophagus. 

Cause — Choke, or stenosis of the oesophagus, is usually 
caused by a foreign body becoming lodged in the oesophagus 
and causing more or less wounding of the mucous membrane. 
The most common objects becoming lodged are potatoes, 
turnips, apples, pears, corn-cobs, splinters, oats, bran, or par- 
ticles of food which are improperly masticated. In some 
cases it may also be due to new formation, parasites or an 
inflammatory condition of the mucous membrane or muscu- 
lature, following narcosis, particles of food may become 
lodged in the oesophagus or compressio'U of the oesophagus 
by tumors or new formations may also cause stenosis. 

In the ox this latter cause is not at all uncommon and 
is seen as the result of a tubercular inflammation of the 
mediastinal or broinchial lymph glands, causing an enlarge- 
ment of these glands so that they press on the oesophagus, 
giving rise to chronic bloating. An exostosis on the first rib 
has also been known to produce stenosis of the oesophagus. 



The Practice of Veterinary Surgery 8i 

It very rarely happens that oesophageal stenosis follows 
wounds or oesophagotomy from cicatricial contraction. 

Symptoms — The animal is unable to swallow food and 
water. If the animal makes an attempt at eating and drink- 
ing the food and water is returned through the nose. After 
two or three days there is discharged from the nose and 
mouth a very foul smelling liquid, which is a mixture of food 
and water that has decomposed, at this time or before 
symptoms of bloating appear. Choke, or stenosis of the 
oesophagus, is frequently accompanied by such complications 
as dyspnoea, coughing and mechanical pneumonia. If the 
exact location of the stenosis cannot be located by external 
manipulation, the passing of a probang readily discloses the 
presence of the stenosis. 

If the stenosis is in the region of the neck, it is spoken 
of as a cervical choke or stenosis, and if the stenosis is in 
the thorax, it is spoken of as thoracic choke or stenosis. 

Prognosis — The prognosis as a rule is favorable but 
should be made with care. 

Treatment — The treatment of this condition is divided 
into operative and non-operative. 

The non-operative form consists in the use of eserine, 
•arecoline or pilocarpine to increase peristalsis. Then pass a 
probang or stomach tube, and ])y pressure try to push the 
obstruction into the stomach. If the obstruction cannot be 
moved allow four ounces of oil and two ounces of chloroform 
to pass onto the object through the tube. This will have a 
tendency to dilate the oesophagus and then by means of the 
probang the object may be pushed into the stomach. 

If the object cannot be removed b}'^ this means, oesoph- 
agotomy is indicated if the stenosis is cervical. After shav- 



82 The Practice of Veterinary Surgery 

ing and disinfecting the area over the stenosis, make an 
incision through the skin down onto the oesophagus, then 
make an incision through the oesophagus on to the foreign 
body. Remove the foreign body, suture the mucous m^em- 
brane and then the muscular coat with continuous sutures 
but separately ; then pack the wound with gauze and apply 
enough sutures to the wound to keep the gauze in position. 
After a few days remove the pack and allow the wound to 
heal by second intention. Following this operation the 
animal should be fed soft food ; rough food should be avoided 
for a week or more. 

In case the stenosis is not visible, or it is thought not 
advisable to perform oesophagotomy, the following line of 
treatment has been found quite satisfactory from a practical 
standpoint: Pass the stomach tube down to the stenosis, 
then make an incision through the skin down to the oesoph- 
agus and separate the oesophagus from the surrounding 
tissue so that it is free. The point of incision should be about 
the middle of the neck. Then tie the oesophagus to the tube 
as tight as possible with a piece of tape. Then by means of 
city water or a pump exert enough water pressure to dilate 
the oesophagus. This pressure must not be exerted for a 
long period of time, but only for a minute or two at a time, 
after which allow the water to escape. After a short time 
this will have a tendency to dilate the oesophagus and the 
stenosis will pass into the stomach. No harm can come from 
this method of treatment, for if the pressure is too great the 
oesophagus will dilate and the foreign body will pass on 
before the oesophagus will rupture. The after treatment con- 
sists in treating the wound as an open wound, allowing it to 
heal by second intention. When the bloating becomes severe 
a trochar should be used under the strictest antiseptic pre- 
cautions. 



The Practice of Veterinary Surgery 83 

DILATATION OF THE OESOPHAGUS. 

Diverticulum. 

Dilatation of the oesophagus is a condition in which 
there is rupturing or stretching of one or more coats of the 
oesophagus, leading to the formation of a pouch. 

Cause — This condition is most frequently caused by 
stenosis, in which food and water lodge above the stenosis 
and form pressure as well as decomposition there is a pouch 
formed in the oesophagus. This may cause a local paralysis, 
or in some cases may be due to an atrophic condition of the 
musculature. This condition has also been known to occur 
from cicatricial contracture, the cicatrix involving the mus- 
culature of the oesophagus and the skin. When this cicatrix 
contracts, the oesophagus will be pulled outward and then 
a pouch forms. 

Symptoms — The symptoms of diverticulum of the 
oesophagus in many respects are similar to stenosis, except 
that the animal eats slowly and on swallowing a portion of 
the food passes down the oesophagus and the remainder back 
through the nostril. There are also sj^mptoms of colic and 
bloating. There is discharged from the mouth and nose a 
very foul sm^elling exudate. If the diverticulum is in the 
cervical portion of the oesophagus it may be seen as well as 
felt. It appears as a pouch and is usually soft in consistency. 
If this enlargement is massaged gently it will disappear and 
the part appears normal. If this condition becomes chronic 
it leads to rapid emaciation. By attempting to pass the 
stomach tube or probang it is usually impossible to pass the 
diverticulum if it is large, as there seems to be something 
that impedes its going further. This does not hold true of a 
small diverticulum. This condition is frequently associated 
with coughing, dyspnoea, mechanical pneumonia, rupture of 



84 The Practice of Veterinary Surgery 

the oesophagus, with septic phlegmon, and empyema of the 
thoracic cavity. 

Prognosis — The prognosis is unfavorable, for sooner or 
later it leads to death. 

Treatment — Prophylactic treatment is the most valuable 
in these cases and consists in feeding soft and moistened feed. 
In chronic cases a portion of the oesophageal wall, that is the 
portion which is affected with the diverticulum, should be 
removed. This may be performed as follows : After thor- 
oughly cleansing and shaving, make an incision through the 
skin to the oesophagus. Then remove an elliptical piece of 
the oesophagus so that when the free edges are sutured the 
lumen will be about normal in size. After removing a portion 
of the oesophagus as described, suture the mucous membrane 
and the muscular coat separately, pack the wound with 
gauze and apply enough in the skin to hold the gauze in 
position. This should be followed by feeding soft feed, and 
in cases where there is great regurgitation of food through 
the nostrils, and if it is feared that food and water may pass 
to the lungs, perform tracheotomy. This will have a ten- 
dency to allow the food and water to pass out of the trachea 
tube instead of passing to the lungs. 

PERFORATION OF THE OESOPHAGUS. 

Rupture. 

Perforation or rupture of the oesophagus is a condition 
in which the walls of the oesophagus are ruptured, allowing 
food and water to pass into the surrounding tissues. 

Cause — Th'C most common causes of this condition are 
external injuries or foreign bodies perforating the oesophagus 
from the inside. A spontaneous rupture has been known to 
occur from fatty degeneration, but is not common. 



The Practice of Veterinary Surgery 85 

Symptoms — The symptoms depend upon the portion of 
the oesophagus affected. 

When the rupture is in the cervical portion, there will 
be a tumefaction on the left side of the neck. This tumefac- 
tion appears very suddenly, is quite large and varies in 
consistency. In some cases it presents symptoms of septic 
phlegmon and emph3'Sema. This emphysematous condition 
frequently spreads, involving the side of the neck and shoul- 
der. Swallowing is difficult and in some cases becomes 
impossible. There is also regurgitation of food through the 
mouth and nostrils. 

When the thoracic portion of the oesophagus is affected 
there is regurgitation of food, salivation, foul smelling dis- 
charge from the nose and mouth, pyo thorax, pneumo thorax 
and severe dyspnoea, followed by septicemia and death in a 
few days. 

Prognosis — The prognosis should be guarded, but is gen- 
erally unfavorable. 

Treatment — The treatment consists in incising the skin 
and suturing the rupture if the cervical portion of the 
oesophagus is involved. Great antiseptic precautions must 
be taken in these cases. The oesophagus should be sutured 
in the usual manner, pack the wound and suture the skin 
sufficiently to hold the pack in place. In several days remove 
the pack and treat the wound with astringent antiseptics. 

If the rupture is in the thoracic portion of the oesophagus 
treatment is of no avail. 

Paralysis of the Oesophagus. 

Paralysis of the oesophagus is usually due to some dis- 
turbance of the central nervous system. It has also been 
known to follow various poisonings, infectious diseases and 
sometimes following anaesthesia. 



86 The Practice of Veterinary Surgery 

Symptoms — The symptoms consist in difficult swallow- 
ing with a slight regurgitation of food. The oesophagus 
becomes packed with food and is greatly enlarged over its 
entire length. This disease is frequently followed by mechan- 
ical pneumonia. There are no symptoms of choke or retching 
and the animals show no signs of pain. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in withdrawing food 
and water from the horse, giving subcutaneous injections of 
strychnine and nerve tonics internally. 



CHAPTER III 

DISEASES OE THE SHOULDER 

Shoulder Lameness. 

SHOULDER lameness is typical swinging leg lameness 
and is not a specific term but is used to designate 
swinging leg lameness, caused by some painful lesion 
interfering with motion in the region of the shoulder. This 
lameness is usually caused by some diseased condition of the 
musculature. In some cases, shoulder lameness may appear 
to be a mixed lameness. This is seen in cases where the 
nerve trunk is afifected. True shoulder lameness makes itself 
manifest when the animal extends or flexes the leg; it becomes 
more severe when going up grade, and less severe going 
down grade. 

Cause — The causative factors producing shoulder lame- 
ness vary according to the part affected. The parts of the 
shoulder affected producing lameness, include the joint, the 
bursa, the musculature, the lymphatics, the vessels, the nerve 
trunks, the bone and the skin. 

Diseases of the skin producing lameness appear mainly 
in the form of phlegmon. Diseases of the joint producing 
lameness appear in the form of contusion, distortion or 
arthritis. Diseases of the musculature appear either in the 
form of rheumatic or traumatic myositis. The intertubercular 
bursa is- affected most commonly in the form of bursitis inter- 
tubercularis. Diseases of the bone are mainly in the form 
of fractures and diseases of the vessel in the form of 
thrombosis. 



88 The Practice of Veterinary Surgery 

Acute Omarthritis. 

Acute omarthritis consists in an acute inflammation of 
the scapulo-'humeral articulation. 

Cause — The most common causes producing acute 
omarthritis are external injuries, contusions, over-exertion, 
or the rupture of a ligament. These causative factors are not 
always severe enough to produce acute clinical symptoms, 
but may produce chronic changes in the joint. Perforating 
wounds to the joint produce suppurative arthritis. In foals, 
this latter disease has been known to occur from suppurative 
thrombo phlebitis. 

Symptoms — The symptoms are marked by the appear- 
ance of high grade lameness, which makes itself manifest 
during motion by abduction, adduction, flexion, or extension 
produced manually. By pressure over the joint, the animal 
shows marked pain. In cases that develop immediately from 
an injury there is swelling, heat and pain in the region of 
the affected joint. 

Prognosis — As a whole the prognosis is quite favorable 
in these cases. Distortions, however, do not respond to treat- 
ment readily and are very apt to produce chronic changes in 
the joint, leading to chronic lameness. Rupture of the 
capsular ligament is most unfavorable and leads to chronic 
deforming arthritis. 

Course — The course is generally short, terminating in 
recovery or chronic deforming arthritis. 

Treatment — The treatment consists in absolute rest, 
moist heat, massage or irritating liniments applied over the 
region affected. 

Chronic Omarthritis. 

Chronic omarthritis consits in the formation of chronic 
deforming arthritis. This develops from a distortion of the 



The Practice of Veterinary Surgery 89 

joint with an injury to the cartilage and capsular ligament 
with hemorrhage into the joint itself. 

Cause — This disease usually develops from the acute 
form in which there was distortion or severe injury. It may 
also be caused by a mild irritation acting persistently, as 
continual driving or over-exertion on hard roads. The pre- 
disposing causes of this disease are very sloping shoulders 
and narrow chest. 

Symptoms — The main symptoms of this disease is mixed 
lameness which causes a short, choppy gait. The stride is 
shortened and excessive extension as well as flexion causes 
pain. There is no painful swelling in the region of the 
shoulder, but there is atrophy of the shoulder as well as of 
the pectoral muscles. This gives the affected joint a large 
appearance and causes it to be more sharply defined. As the 
case develops an exostosis forms around the border of the 
joint so that by palpation this may be readily felt. After 
the case has been of very long standing there is pain shown 
in passive movements of the joint, as abduction, adduction, 
flexion or extension. After a long period of rest this lame- 
ness disappears and reappears with exercise. Cocaine injec- 
tions do not stop the lameness. 

Chronic Changes in the Joint. 

The same chronic changes take place here that appear in 
any deforming arthritis, chronic spavin, ringbone and gonitis. 
In the bone there is the appearance of a chronic inflammatory 
osteoporosis and osteosclerosis, which gives the cut surface 
of the bone a dirty red appearance. There is the formation 
of new bone and enlargement of the joint surface. The 
cartilage is soft in consistency and very vascular. It often 
happens that there are pieces of cartilage floating free in the 
joint cavity as the result of osteochondritis. The surface and 

7 



go The Practice of Veterinary Surgery 

edges of the cartilage are covered with very small, wartlike 
exostoses; these eventually become larger and cause a com- 
plete anchylosis of the joint. The joint capsule becomes 
thickened and the synovial membrane is swollen and small 
portions become dislodged, leading to the formation of free 
bodies in the joint cavity. 

Prognosis — The prognosis of this disease is usually un- 
favorable and should be made with care. Severe cases are 
always to be considered incurable, while milder cases may be 
relieved by treatment. 

Treatment — The treatment consists in rest ; this is the 
most essential part of the treatment, along with rest blisters, 
and firing may be resorted to. The atrophy of the muscles 
may be treated with massage, injections of silver nitrate, 
chloroform or by setoning. 

Traumatic Myositis of the Shoulder Muscles. 

This consists in an inflammation of the shoulder mus- 
cles as the result of external injury. 

The muscles of the shoulder which are commonly in- 
volved in this disease are the mastoido humeralis and the 
biceps brachi. 

Cause — The causes of myositis are contusions, bruises, 
partial or total laceration, coming in contact with sharp ob- 
jects, kicks, over-exertion in pulling or running. 

Symptoms — The symptoms of traumatic myositis are 
characterized by typical supporting leg lameness. By pal- 
pation there is usually found a circumscribed, painful, swollen 
and warm area in the region of the muscle afifected. There 
may also be haemotoma or the formation of muscle hernia. 
These, however, are very rare, but should always be 
looked for. 



The Practice of Veterinary Surgery 91 

Prognosis — The prognosis of traumatic myositis taken 
as a whole is quite favorable. It is probably the most yield- 
. ing of shoulder lameness to treatment. 

Treatment — The treatment consists in rest, moist heat, 
massage, mild irritating liniments and in severe cases blis- 
tering or eventually the use of the cautery. 

Rheumatic Myositis. 

This is supposed to be due to the so-called catching cold. 
This disease is very often confounded with haemoglobinaemia, 
and a very guarded diagnosis should always be given. Ex- 
treme heat or a very long period of rest seems to predispose 
the animal to this disease. 

Symptoms — The symptoms of rheumatic myositis are 
very easily recognized b}' a short, choppy gait and swinging 
leg lameness which improves on motion. This lameness will 
disappear and reappear without any apparent cause. This fact 
is very helpful in diagnosing the disease. It may also occur 
that the lameness will shift from one part of the body to the 
other. The muscles themselves are swollen, painful to the 
touch, and in rare cases the muscles become infiltrated. 

Prognosis — The prognosis of this disease should be 
guarded and given only after a very thorough examination, 
as this disease does not yield to treatment very readily. 

Treatment — The treatment consists in massage, moist 
heat, and mild irritating liniments, as camphor, turpentine or 
iodine. In more severe cases blistering or subcutaneous in- 
jections of veratrine or morphine may be used. Internally 
give salicylic acid, salicylate of soda, or potassium iodide. 
Salicylates are considered specifics for this disease. It is not 
best to give the animal absolute rest, but a little gentle exer- 
cise should be given daily. 



92 The Practice of Veterinary Surgery 

Bursitis Intertubercularis. 

This consists of an inflammation of the intertubercular 
bursa. The diseases of this bursa are divided into two classes, 
suppurative and non-suppurative. 

Cause — The aseptic or non-suppurative inflammations of 
this bursa, are the result of contusions or over-exertion, 
causing a straining of the tendon playing over the bursa, thus 
bruising the bursa. Suppurative inflammation of this bursa 
may follow infectious disease, but as a rule it is due to punc- 
tured wounds oi- septic phlegmon. According to the course 
there are two forms, acute and chronic. 

Symptoms — Aseptic bursitis intertubercularis is the most 
common form appearing in practice, and consists of a serous 
or sero fibrinous bursitis. Acute cases present all of the 
symptoms of an acute serous bursitis. In chronic cases the 
bursa becomes enlarged, thickened, and the inner surface is 
covered with granulations, causing it to become attached to 
the tendon. In very severe cases this bursa ossifies 
or gives rise to exostosis on the humerus. This condition 
gives rise to a typical swinging leg lameness, backing the 
animal or pressing over this region is very painful. Locally 
there is swelling heat, pain, and in cases of fibrinous bursitis 
there is crepitation. If the acute serous bursitis becomes 
chronic, it lead's to the formation of a soft, painless, fluc- 
tuating tumefaction. 

Prognosis — The prognosis of these cases is usually quite 
favorable, although in chronic cases the lameness is of very 
long standing. 

Treatment — The treatment of the aseptic form consists 
of rest, massage, moist heat, and irritating applications, as 
blistering, etc. After a few days make a deep incision into 
the tumefaction, remove its contents and destroy the capsule. 



The Practice of Veterinary Surgery 93 

In cases where there has been ossification of the bursa, total 
extirpation of the entire mass is essential. 

Symptoms — The suppurative form usually appears after 
a direct opening of the bursa, or from the spreading of a 
phlegmonous process, which is suppurative in character. 
This form is characterized by swinging leg lameness, sup- 
purative phlegmon, heat and pain locally. There may or may 
not be a discharge. If it is produced by a punctured wound, 
then there will be discharged from the wound an oily dis- 
charge, which is an admixture of pus and synovia. 

Prognosis — The prognosis is usually grave. After this 
disease has run a course of several days, as a rule the animal 
develops symptoms of septicaemia and death may follow if 
not treated. 

Treatment — The treatment of the suppurative form con- 
sists in free incisions, antiseptic irrigation and disinfection. 
In cases where septicaemia develops, quinine, potassium 
iodide, echinacea, echafolta or silver colloids should be given, 
as well as nuclein, antistreptoccic serum or bacterins. 

Fracture of the Scapula and Humerus. 

Fracture of these bones is quite common, as it usually 
appears as the result of coming suddenly in contact with a 
stationary object. A fracture is easily noticed and can be 
accurately diagnosed. 

Symptoms — The symptoms are a suddenly appearing, 
severe swinging leg lameness. This lameness is so severe 
that it causes the animal to locomote on three legs. The 
affected-leg is left hanging and no attempt is made at moving 
it. Locally there is swelling, heat, pain and crepitation may 
be felt or heard during passive movements. By manipulating 
the leg it may be readily seen that the leg has abnormal 



94 The Practice of Veterinary Surgery 

movements, and appears to be free to move in any direction. 
Frequently the affected leg is shortened as the result of mus- 
cular contraction. 

Prognosis — The prognosis of these cases, so far as the 
life of the animal is concerned, is good. These cases usually 
heal readily but the animal is left worthless for service. 

Treatment — It is usually advisable to destroy the animal 
unless it is very valuable, and is to be used for breeding 
purposes. Intreating a fracture in a horse or ox a great many 
complications arise which often prove fatal. The one fact that 
the animal must remain standing in one position for so long 
a time gives rise to severe atrophy, laminitis, or the os pedis 
may change its position, giving rise to severe chronic changes 
in the foot. It is usually necessary to confine a horse in a 
cast, splints, or a sling. This gives rise to decubitus, which 
is frequently followed by a fatal septicaemia. In the dog, 
however, about ninety-five per cent of these cases are readily 
curable without any complications. 

Paralysis of the Suprascapular Nerve. 

The causes of paralysis of the suprascapular nerve are 
usually of traumatic origin, such as contusions, running into 
foreign objects, laceration of a muscle, or fracture of the 
scapula in which the nerve trunk falls between the edges of 
the broken bone, etc. 

Symptoms — The symptoms of this condition are a char- 
acteristic outward movement of the shoulder during motion. 
The shoulder seems to push outward and this movement or 
position is very characteristic. The elbow is not against the 
body but appears similar in position to that of the ox. There 
is a distinct space between the thoracic wall and the shoulder 
muscles, and after a few days there is marked atrophy of the 
shoulder muscles. 



The Practice of Veterinary Surgery 95 

Prognosis — The prognosis of this disease is not favor- 
able, especially if marked atrophy develops suddenly. 

Treatment — The treatment consists in rest, massage, 
electricity, blistering and subcutaneous injections of strych- 
nine, silver nitrate or veratrine. Internally potassium iodide, 
mercuric iodide or strychnine should be given along with 
wholesome, nutritious food. The animal should have gentle 
exercise daily. If this is impossible regular movements of 
abduction and adduction should be practiced. 

Radial Paralysis. 

Radial paralysis consists in a motor paralysis of the radial 
nerve and seems to affect the shoulder muscles mainly. 

There are two forms of radial paralysis from a practical 
standpoint ; these are neurogenous and myogenous. 

Cause — Neurogenous paralysis is a very common form 
in the horse and is usually the result of a traumatism to the 
side of the shoulder where the radial nerve passes over the 
humerus. It appears very frequently after casting, being 
cast in the stall, or when the animal has been down and lying 
in one position for a great time. Injuries to the central part 
of the humerus seem to be the most important in bringing 
on this disease. 

Myogenous radial paralysis usually occurs as a second- 
ary disease in the form of parenchymatous myositis, and 
follows an attack of azoturia. 

Symptoms — The symptoms of radial paralysis consist in 
a peculiar breaking over when weight is placed on the leg 
during the act of walking. It seems as though the leg can- 
not support the weight of the part. The leg is usually 
extended and the carpus flexed. The gait is quite uncertain 
and the animal stumbles. If the disease does not disappear 
rapidly, there is a marked muscular atrophy present. 



96 The Practice of Veterinary Surgery 

Prognosis — The prognosis of radial paralysis is quite 
favorable. These cases usually yield to treatment in from 
ten days to one month. 

Treatment — The treatment consists in massage, electric- 
ity, blisters, liniments, subcutaneous injections of strychnine, 
and internally potassium iodide, mercuric iodide and arsenic 
preparations. The animal should be put on a regular diet 
and given small quantities of good, nutritious food. 

Thrombosis of the Axillary and Humeral Arteries. 

This disease appears quite frequently in the horse, and 
as a rule it is due to a chronic deforming endarteritis or the 
lodging of an embolus, which is formed from endocarditis. 

Cause — The cause of this condition is faulty circulation. 

Symptoms — The disease is characterized by an intermit- 
tent high grade shoulder lameness, which as a rule arises 
from no apparent cause; that is, there is no apparent visible 
diseased condition around the shoulder. This lameness ap- 
pears only during exercise and disappears after a period of 
rest. The history of such a case would be as follows : On 
exercising the animal a slight lameness is noticed, which 
becomes gradually worse as exercise is continued. As the 
lameness grows worse the animal becomes uncertain in gait, 
stumbles, drags the foot and eventually goes down. Along 
with this lameness there are other symptoms, as profuse 
sweating, rapid pulse and rapid breathing. The heart has 
undergone a compensatory hypertrophy, and as a result the 
heart beat may be heard distinctly several feet away from 
the animal. The pulse of the radial artery is also absent. 
The affected limb is cold and there is no response to the 
prick of a pin. After a short period of rest these symptoms 
disappear entirely. In grey horses there may be a similar 



The Practice of Veterinary Surgery 97 

set of symptoms as the result of melanosis of the axillary- 
lymph glands. 

Prognosis — The prognosis should be guarded, but is gen- 
erally unfavorable. 

Treatment — The treatment of a thrombus is useless, as 
it is an incurable condition. It frequently occurs that after 
the disease has run a course of from six months to a year, 
it is practically cured by collateral circulation. This col- 
lateral circulation supplies the blood, and the function of the 
leg returns, and the animal may again be useful. Therefore 
it is not advisable to have these animals destroyed at once, 
but they should be given a long period of rest on good, 
nutritious food, along with tonics and absorbents to assist in 
the canalization of the thrombus. 

DISEASES OF THE ELBOW AND FOREARM. 

Shoe Bcil. 

This consists in a tumor formation on the point of the 
elbow as the result of contusions. This malady occurs very 
frequently in the horse. 

Cause — The most common cause is lying on the point 
of the shoe. It may be due to a great variety of causes, but 
all of these are in the nature of a contusion. In glanders a 
metastatic bursitis may appear during the course of the dis- 
ease, in which case it would appear symptomatically. 

There are two forms of this disease, aseptic and sup- 
purative or septic. 

Cause — The aseptic form of shoe boil is due entirely to 
traumatisms without infection. 

Symptoms — These cases appear very suddenly, usually 
over night. There is found a hot, painful, fluctuating, cir- 



gS The Practice of Veterinary Surgery 

cumscribed tumefaction of the skin and subcutaneous tissue. 
There may also be a sero hemorrhagic bursitis of the bursa 
olecrani. This usually appears in the form of a haemotoma or 
serous infiltration of the tissues in this region. It may occur 
that in mild cases there will be a total resorption of the fluid 
in a very short time. In very severe cases that become 
chronic, there is hygroma formation with parabursitis result- 
ing in a chronic thickening of the walls of the bursa with 
tumor formation. This tumefaction resembles a fibroid 
tumor, is movable, and appears immediately over the 
olecranon process. 

Cause — The suppurative form of shoe boil is caused by 
a contusion with the entrance of pus cocci into the subcutane- 
ous tissue and the bursa olecrani. This gives rise to a 
subcutaneous phlegmon or suppurative bursitis, with para- 
bursitis and eventually necrosis of the skin. This in turn 
causes a diffuse swelling, which is very painful and has a 
tendency to necrosis and severe general symptoms. This 
form does not appear as suddenly as the aseptic form. 

Treatment — The treatment of the aseptic form consists 
in making a free incision into the tumefaction and draining. 
This incision, however, must not be made too early, but after 
four or five days, so as to allow the acute inflammatory symp- 
toms to subside and a thrombus to become organized in the 
injured vessel. The wound may be dressed in the usual way 
or painted with Lugol's solution. Hygromas of long stand- 
ing should be completely extirpated with the knife. Doubtful 
cases may be sloughed with escarotic paste. This, however, 
is not nearly as satisfactory as extirpation. After removing 
the tumefaction the wound may be treated as an open wound, 
or it may be sutured by Bayer's method and treated ac- 
cordingly. 

The treatment of a suppurative shoe boil consists in the 
removal of the entire tumefaction as soon as possible. It is 



The Practice of Veterinary Surgery gg 

not advisable to remove this tumefaction until the acute 
inflammatory symptoms have subsided. The entire mass 
should be removed in toto. The after treatment consists in 
antiseptic irrigation and dusting powders. 

From a prophylactic standpoint it is well to keep the 
animal bedded very heavily with straw, wear a roll or pad 
of some description, and in this way prevent profuse hem- 
orrhage, and keep in a box stall or tie loosely. 

Inflammation of the Radio-Humeral Articulation. 

The causes of this disorder are usually traumatic in 
origin. They may consist in contusions or perforating punc- 
tured wounds. It frequently occurs that a spread of an 
inflammation may take place and affect the joint. A metastatic 
arthritis of this joint is very rare. The usual form is an 
acute suppurative arthritis. 

Symptoms — The symptoms are severe swelling around 
the joint, very high grade lameness, as well as the discharg- 
ing of pus and synovia from the wound. By probing the 
wound, the joint surface will be found to be laid bare. This 
disease is accompanied by severe general symptoms of 
septicaemia. If this disease does not kill the animal quickly 
there will be dropsy of the legs, and severe atrophy of the 
shoulder muscles. 

Prognosis — These cases do not respond to treatment 
readily and are practically incurable. Very mild cases that 
have had only a short course may be treated successfully. 

Treatment — The treatment consists in enlarging the 
wound so as to allow the finger to pass in, then irrigate very 
thoroughly with bichloride solution one to two thousand. 
After a very thorough irrigation, inject into the joint cavity 
a solution of iodoform and ether one to ten, and pack with 



•ido The Practice of Veterinary Surgery 

iodoform gauze. At first this treatment should be repeated 
every two hours. As the discharge becomes lessened and the 
general symptoms abate, the periods of treatment may become 
lengthened to four or six hours. Internally give large doses 
of quinine, echafolta, echinacea or potassium iodide. Severe 
cases should be destro3^ed at once, as these cases are very 
painful and incurable. Polyvalent or autogenous bacterins, 
as well as antistreptococcic serum, should be used, for it has 
been proven beyond a reasonable doubt, that they are useful 
in the treatment of these cases. 

Fracture of the Radius and Ulna. 

Fractures of these bones occur most frequently in dogs 
and horses. 

Cause — The cause is usually some mechanical injury. 
There are, however, such predisposing causes as osteomelacia, 
rickets, etc. 

Symptoms — The symptoms are high grade lameness, loss 
of function, sweating and fast breathing. Locally there is 
heat, pain on pressure, and crepitation. The leg is found to 
have abnormal movements when manipulated manually. 

Prognosis — The prognosis is unfavorable in horses and 
favorable in dogs. 

Treatment — The treatment consists in bandaging and 
casting in young horses, cows and dogs. In cows and dogs 
these fractures heal very readily without any treatment at 
all, except perfect rest, which is insured, by the application 
of a cast. It is usually impractical to try and have a union 
in aged horses. The bone will unite but as a general rule 
the function of the leg is disturbed indefinitely. It is usually 
advisable to destroy adult horses with a fractured radius 
^nd ulna. 



The Practice of Veterinary Surgery loi 

Fracture of the Ulna. 

Fractures of the ulna alone usually affect the olecranon 
process. 

Symptoms — The symptoms are abnormal movement of 
the olecranon, swelling, pain, crepitation in that region, and 
high grade lameness. 

Treatment — The treatment of this class of fracture is the 
application of a cast, splints, bandaging and plenty of rest 
in a sling, along with nourishing food. 

DISEASES OF THE CARPUS. 

Wounds. 

Contusions of the carpal joint are usually the result of 
falling and striking the knee on the ground. These contu- 
sions are of various grades, depending upon the force of the 
contusion. Superficial skin wounds heal very rapidly and 
may be treated with a solution of lead acetate, zinc sulphate 
or alum. Second grade contusions assume a more serious 
nature and as a result there is the formation of edema or a 
hematoma. These hematomas appear in the form of circum- 
scribed, fluctuating, painless areas. More serious cases may 
result in phlegmon, abscess formation or hygroma if the 
bursa is injured. 

Treatment — The treatment of these consists in moist 
heat, puncture, incision, excision, drainage and antiseptic irri- 
gation. 

Contusions of the third grade lead to necrosis of the skin 
and subcutaneous tissue. The treatment of these consists in 
removal of the necrotic areas with disinfection. 



I02 The Practice of Veterinary Surgery 

Wounds of the skin are usually three-cornered and ex- 
tend to the carpal fascia in depth. These wounds are very- 
hard to treat successfully, on account of the movement of 
the carpal joint. They are best treated by bandages and 
caustics as formaldehyde, silver nitrate, etc. 

Wounding- and contusing of the tendons and tendon 
sheaths in this region leads to a serous or suppurative tendo- 
vaginitis, and in some cases necrosis of the tendons. The 
treatment of this is very difficult and consists in free incision, 
removal of necrotic and suppurative areas with irrigation of 
tincture of iodine and iodoform ether. These wounds should 
be very carefully bandaged. It is well to use bacterins along 
with the other treatment in these cases. 

Contusions of the joint with an abrasion of the skin 
usually lead to suppurative arthritis with a consequent 
septicaemia or pyaemia. The treatment for this is the same 
as for an open joint. 

Aseptic contusions of the bone lead to either exostosis 
formation or fracture. The so-called knee spavin is the result 
of an injury to the bone from falling. These spavins are 
treated most successfully by the cautery, but are generally 
considered incurable, because they give rise to a very painful 
and mechanical lameness. 

By firing and blistering the acute lameness may be over- 
come, but there is always a mechanical lameness left over, 
which renders the animal practically useless for a gait faster 
than a walk. 

Knee Boil. 

By the term knee boil is meant any tumefaction which 
may form on the anterior surface of the carpus. This is seen 
most commonly in the horse, but is very rare. 

Cause — This condition is usually the result of a continual 
irritation, bruising from falling, injuries to this part during 



The Practice of Veterinary Surgery 103 

the act of lying down or getting up, or of some specific infec- 
tion. From a pathological point of view these tumefactions 
may be elephantiasis of the skin, hygroma of the bursa pre- 
carpalis with parabursitis or an encapsulated or organized 
hematoma of the subcutaneous tissue or fibrous tumors. 

Symptoms — These tumefactions nearly always appear in 
the form of soft, fluctuating, painless swellings. If the skin 
is involved they are very firm. Hygromas and hematomas 
are soft and fluctuating. On the external surfaces these 
tumefactions are covered with a tough skin, which is the result 
of the irritation. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment of this form of knee boil con- 
sists in incision, excision, injections of caustics, as iodine, 
silver nitrate and drainage with irrigation. 

A second class of knee boil is due to a chronic tendo- 
vaginitis of the tendon sheath of the extensor carpi. These 
are true hygromas with an excessive thickening of the skin 
surrounding them. These are either traumatic or tubercular 
in origin. These tumefactions which are due to tuberculosis 
may be distinguished from the traumatic form in the follow- 
ing manner : The traumatic tumefactions are painless, cir- 
cumscribed, fluctuating swellings, while those of tubercular 
origin are diffuse, painful, hot swellings, which entirely en- 
circle the carpus and in some cases afifect the forearm. This 
last form gives rise to lameness, general debility and atrophy 
of the shoulder muscles. 

On post mortem the tendon sheaths are found to be very 
much thickened, hyperaemic and the walls are covered over 
with fibrin or there may be numerous floating particles in the 
fluid. A positive diagnosis of this condition can only be made 
by the tuberculin test. 



I04 The Practice of Veterinary Surgery 

A third class of knee boil is due to chronic periarthritis 
and arthritis of the carpus with the formation of exostosis 
and ankylosis. These tumefactions are easily diagnosed by 
their consistency. 

Acute Arthritis of the Carpus. 

An acute suppurative arthritis of the carpus is the result 
of perforating wounds involving the joint, or in some instances 
it may occur by metastasis. 

Cause — This is usually the result of stumbling or falling. 

Symptoms — The symptoms of suppurative arthritis are 
discharging of synovia mixed with pus (making a cream- 
colored fluid), severe swelling of the entire region, high grade 
lameness and general symptoms of septicaemia. 

Prognosis — The prognosis of this disease is not favor- 
able, but may be rendered more favorable, depending upon 
the care and treatment. It is very rare that the entire joint 
becomes infected. If only one portion of the joint is affected 
the prognosis is more favorable. 

Treatment — The treatment is the same as for an open 
joint. 

Chronic Arthritis of the Carpus. 

This is usually a chronic deforming arthritis with 
exostosis formation and enlargement of the entire joint. This 
malady occurs most commonly in the horse, but has also been 
seen in the ox and dog. This condition is also known as 
"knee spavin," and constitutes one form of the same. 

This condition gives rise to a chronic incurable lameness 
which lasts for months and years (distinguished from knee 
spavin due to accidental injury). The exact cause for this 
disease is unknown at present, but is supposed to be due to 



The Practice of Veterinary Surgery 105 

faulty position from shoeing, rupture of the lateral ligaments 
of the carpus, or following fractures of the individual carpal 
bones. 

This disease is practically incurable where there is a large 
exostosis formation. The lameness may be removed to a 
certain extent by median or ulnar neurectomy. If the 
exostosis interferes with the motion of the joint it is useless 
to treat the case on account of the mechanical lameness which 
it causes. 

Hygroma Formation on the Carpal Joint. 

This condition consists in a chronic serous bursitis, lead- 
ing to hygroma formation. This so-called knee gall, or 
thoropin, is a typical joint hydrops. 

Symptoms — Hygroma of the carpal joint consist in a 
circumscribed, round, painless, fluctuating, cold swelling, 
usually appearing on the inner surface of the radius just above 
the carpus. This gives rise to no apparent symptoms of lame- 
ness and constitutes a blemish affecting only the beauty of 
the horse. 

Treatment — The treatment consists in extirpation if pos- 
sible, otherwise a free incision may be made and the capsule 
destroyed with iodine. Puncture and aspirations are usually 
very dangerous as well as disadvantageous, because it gives 
rise to infection. 

The so-called ''road puffs," or "road galls," are also 
hydrops of the tendon sheaths. They are oblong, fluctuating 
and painless swellings, which from a practical standpoint are 
harmless. 

The treatment of these consists in elastic bandages, mas- 
sage, irritating liniments and eventually free incision into the 
swelling, destroying its capsule with iodine followed by anti- 
septic irrigation. 
8 



io6 The Practice of Veterinary Surgery 

DISEASES OF THE METACARPUS. 

Splints. 

Splints are small exostosis of various shapes that appear 
on the side of the metacarpus a little above the center of the 
bone ; about seventy-five per cent appear on the inner side 
of the front leg. They very rarely appear on the hind leg. 

Cause — From a practical standpoint there are two kinds 
of splints ; these are traumatic and spontaneous in origin. 

Traumatic splints are usually caused as follows : When 
the animal is in motion, there is usually a certain amount of 
friction or motion between the large and small metacarpal 
bones. Faulty shoeing, faulty position in standing, stumbling 
and uncertainty in gait causes excessive friction between the 
large and small metacarpal bones. This increased friction 
gives rise to a periostitis ; this in turn becomes ossifying, 
laying down new bone forming the visible enlargement. 
Some authorities state that standing with the fore feet far 
apart causes a stretching of the fascia and there is an uneven- 
ness of pressure ; this in turn injures the periosteum to such 
an extent that there is an ossifying periostitis present. 

The supposition is that spontaneous splints arise in the 
following manner: There is an inflammation of the bone set 
up from some internal cause. This ostitis eventually becomes 
rarifying in character, irritates the periosteum and this then 
gives rise to an exostosis formation. In these cases the 
exostosis is not a local disease process in itself, but is simply 
a symptom of an existing ostitis. 

Symptoms — The symptoms of splints are as follows : 
Along the surface of the large metacarpal bone, there are 
exostoses varying in shape and size. These are not attached 
to the skin and are painful on pressure when they arise, and 



The Practice of Veterinary Surgery 107 

during the acute inflammatory process, but later on become 
painless. In the beginning these splints often cause lame- 
ness, which is very severe, and at this time they are usually 
softer in consistency than bone. After ossification and 
adhesion takes place, they cause no lameness, and are only 
blemishes. It may happen that a splint will appear on the 
back of the bone under the tendon. 

These cases are incurable, because they interfere with 
the action of the tendon, and the animal sufifers from a chronic 
lameness. Splints are most easily diagnosed by passing a 
piece of metal over them. This gives rise to considerable 
pain. In blind or occult splint there is a typical splint lame- 
ness but no exostosis. This can also be diagnosed by a piece 
of metal or cocaine. The kind of lameness shown in splint 
lameness is a mixed one and varies with the case, but usually 
grows worse on exercise. 

Prognosis — The prognosis as a whole is favorable. 

Treatment — The treatment of splints consists in the 
application of absorbents, blistering agents, and eventually 
the cautery. After ossification takes place there is no treat- 
ment required. The essential treatment is rest; a long period 
of rest will often be sufficient treatment. Tincture of iodine 
applied with a brush, or iodine, alcohol, ether, and flexible 
collodion will cause their resorption in a great many cases. 
If the exostosis is quite large and the animal valuable, it may 
be removed with a chisel and hammer. 

Tendonitis. 

Tendonitis consists in an inflammation of the tendons 
which is either acute or chronic. Tendonitis of the flexors 
of the foreleg is one of the most common surgical diseases 
of the horse. Of the flexor tendons, the suspensory ligament 
is involved most commonly. 



io8 The Practice of Veterinary Surgery 

Cause — Tendonitis is usually due to over-exertion and 
over-stretching- of the tendon, probably due to faulty shoeing. 
It may also be caused by bruising or contusions. Small, weak 
tendons and large, loose tendons seem to be somewhat pre- 
disposed to this condition. 

Symptoms — The symptoms of tendonitis are swelling, 
heat, and pain in the region of the affection. The animal 
afifected is extremely lame, the lameness becoming more 
severe on exercise. If there is a partial rupture of a tendon, 
there will be one particular, fluctuating spot, which at first 
will be very painful and later on becomes painless. Eventually 
this fluctuating spot becomes very hard and forms a so-called 
tendon callous. If the disease becomes chronic, there is a 
shortening of the tendons, forming the so-called tendenous 
stiltfoot. In practice it usually occurs that all of the tendons 
become involved, but it may happen that one tendon will be 
affected alone. 

Prognosis — The prognosis of acute tendonitis is quite 
favorable, while in chronic tendonitis it is more or less un- 
favorable. 

Treatment — The treatment of acute tendonitis consists in 
rest, massage, cold in form of ice or running water, in the 
first stages. After a few days, apply moist heat in the form 
of a Priesnitz pack, irritating liniments or antiphlogistine. 
If the case is not better or entirely healed in ten days, it is 
well to apply a severe blister and give a long period of rest. 
If the case is near at hand, good results may be had from the 
application of a cast. This assures perfect rest and no other 
treatment is needed. It often occurs that cases will yield at 
once to a cast that will not yield in any other way. Chronic 
tendonitis seems to yield only to blistering under a bandage 
or the cautery, along with a long period of rest. 



The Practice of Veterinary Surgery 109 



Stiltfoot. 

This consists in a contraction of the metacarpo-phalangeal 
articulation with a loss of free movement. In this condition 
this joint assumes the position of excessive volar flexion. 
This gives rise to a peculiar position of the joint and is fre- 
quently accompanied by an osseus development around the 
bone. There are two forms of stiltfoot : Tendon stiltfoot and 
articular stiltfoot. 

Cause — Tendon stiltfoot is caused by a contraction of 
the flexor tendons due to chronic tendonitis, while articular 
stiltfoot is due to an anthrogenous contracture following 
arthritis, periarthritis, distortion and subluxation of the fet- 
lock joint. 

Prognosis — The prognosis of stiltfoot depends upon the 
cause. Articular stiltfoot is incurable, while tendon stiltfoot 
yields to treatment in most instances. 

Treatment — The treatment of tendon stiltfoot consists in 
tenotomy. The indication for tenotomy must be very exact 
or the operation will be a failure. It is advisable to cast the 
animal and determine which tendon or tendons are contracted. 
After ascertaining this information, sever the tendons one at 
a time, until the leg returns to its normal position. The after- 
treatment consists in shoeing with a plate and giving perfect 
rest for two months. After this time the animal may be put 
to work. It may be necessary in some cases to apply a cast 
to the leg in order to have perfect union where the animal is 
quite restless. Tenotomy is contra indicated in the early 
stages, when there is acute tendonitis present. 

The seat of operation is midway between the carpus and 
fetlock or tarsus and fetlock. This operation must be per- 
formed under the strictest antiseptic precautions, so that 
healing by first intention is assured. The incision through 



no The Practice of Veterinary Surgery 

the skin should be large enough to admit a probe pointed 
bistuory. Insert the bistuory through the skin, push the 
artery vein and nerve behind it, then pass it down behind the 
perforans. Then sever the tendons by a short sawing move- 
ment of the knife. It is not necessary to suture this wound 
because it is so small, but apply an occlusive bandage. 

Stiltfoot in Foals. 

Stiltfoot occurs in the front legs of foals from no apparent 
cause. It does not follow tendonitis and seems to appear 
spontaneously. There are two forms which may be diagnosed 
in practice. These are acquired and congenital. 

Congenital stiltfoot is probably the most common form 
and is seen in the lighter breeds of horses. The foals at the 
time of birth have a contraction of the flexor muscles, and 
as a result, they can neither walk nor stand. The cause is 
undoubtedly muscular, and the muscles are affected as well 
as the tendons. Some authorities have stated that this is 
due to faulty position while in the uterus. 

Acquired stiltfoot in foals usually occurs about the sixth 
month, but may appear as late as two years after birth. This 
is seen in colts that are poorly nourished or that have been 
stabled constantly or those that are suffering from rachitis, 
which affects the joints or the bones themselves. 

Symptoms — The symptoms of acquired or congenital 
stiltfoot in foals are first stiffness in the gait, the fetlock 
becomes straightened, the toes stick in the ground and the 
animal walks on the tips of the toes. The flexor tendons 
become thickened, the animal has a tendency to be down con- 
tinually and there is general debility and emaciation. 

Prognosis — The prognosis of congenital and acquired 
stiltfoot in foals is quite favorable. Very severe cases of 
course are less favorable. 



The Practice of Veterinary Surgery iii 

Treatment — Congenital stiltfoot is most successfully- 
treated by a plaster or a starch cast. If this does not bring 
perfect results, tenotomy should be resorted to. This will 
bring positive results almost immediately. The treatment of 
acquired (rachitis or rheumatic) stiltfoot in foals, consists in 
general treatment of calcium, arsenic or iodine preparations, 
good food and proper care. Locally, massage, liniments and 
casts should also be used. 

Rupture of the Flexor Tendons. 

Rupture of the flexor tendons usually occurs in the fore- 
limb of the horse. 

Cause — The causes may be grouped as external and 
internal. The external causes are the most common and are 
due to over-exertion and contusion. A tendon rupture may 
also occur from necrosis of the tendon or the fascia surround- 
ing the tendon. Tendon rupture from internal causes usually 
results from insufficient nutrition following neurectomy, and 
such diseases as osteomalacia and rachitis. 

Symptoms — Tendon rupture is characterized by a turn- 
ing up of the toe and a high grade lameness. During motion 
the heel strikes the ground first, then the volar surface and 
in most instances the toe is turned upward. By examining 
the hoof manually, it is found to have great freedom of move- 
ment. At the point of rupture there is a soft fluctuating 
swelling, which is a haematoma. 

Prognosis — The prognosis is unfavorable in most cases. 

Treatment — The treatment of tendon rupture is of very 
little value. The animal must have the aflfected leg put in a 
cast followed by a long period of rest. Sometimes there are 
severe after symptoms, as a chronic incurable lameness, and 



112 The Practice of Veterinary Surgery 

it becomes necessary in these cases to resort to the cautery 
or blistering. 

These animals become greatly emaciated and may suffer 
from septicaemia or decubital gangrene. 

Fracture of the Metacarpus. 

The cause of fracture of the metacarpus is usually due to 
accidental injuries. The symptoms are high grade lameness, 
heat, pain, crepitation at the point of fracture, swelling and 
abnormal movement of the foot. Treatment is the same as 
in any fracture. 

Scratches. 

This is an inflammation of the skin in the region of the 
fetlock. It appears mostly in coarse-bred and phlegmatic 
animals. 

Cause — Scratches is usually caused by such external 
causes as filth, blistering, chemical irritation or infection. 
These causes may be direct or indirect. Direct causes may 
be excessive moisture, sand, mud, soap, salt, ground stone 
from macadamized roads, ammonia or salt from streets, ice, 
infection of pus cocci, necrosis bacilli, etc. 

Course — According to the course, scratches may be acute 
or chronic. From a clinical standpoint, there are the follow- 
ing forms : Eczematous dermatitis, verrucose dermatitis, 
gangrenous dermatitis or grease heal, and erythematous 
dermatitis. 

Eczematous dermatitis usually appears as an acute 
erythematous condition accompanied by a painful swelling. 

Symptoms — After this condition has existed several days 
it reaches the so-called moist stage, in which there is found 
small vesicles between the hairs, which contain a clear serous 
exudate. These vesicles break and discharge this exudate on 



The Practice of Veterinary Surgery 113 

the hair, forming a sort of mat. This mass of serum and hair 
has a tendency to become purulent. After about one week 
crusts form as the result of the serum becoming dried. Mild 
cases heal after this crust formation and there is left behind 
a few dry scabs. Severe cases do not heal after treatment 
but continue to discharge. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in rest, cleanliness, 
carefully bandaging the part and the application of some 
drying and healing agent, as Goulard's extract and lard, equal 
parts, zinc oxide ointment, equal parts of tincture of iodine 
and glycerine and carbolic acid, five per cent solution of tannin 
or zinc oxide in the form of dusting powder. 

Verrucose dermatitis usually appears in the form of a 
chronic hyperplastic dermatitis. 

Symptoms — This form of scratches is characterized by a 
very foul smelling, suppurative secretion, which leads to 
ulceration and multiple granuloma formation. After this 
disease has run a long course, the skin becomes thickened, 
resulting in sclerosis of the skin and subcutaneous tissues, 
the hair becomes short and stubby, and in rare cases this will 
spread, giving rise to gangrene of the frog. 

Prognosis — The prognosis is rather unfavorable and 
should be made with care. 

Treatment — The treatment of this condition is very 
tedious. Before treating, the leg should be thoroughly 
cleansed with some antiseptic soap and water, as green soap 
and creolin one to ten. After this it is best to apply alcoholic 
agents,, as a one per cent solution of creosote, bichloride one 
to one" thousand, or carbolic acid one per cent in alcohol. 
These should be applied with a brush. Such other remedies 
may be used as picric acid ten per cent, formalin two per cent 



114 '^^^ Practice of Veterinary Surgery 

or chromic acid ten per cent ; this should be applied under a 
bandage. Severe cases that will not yield to treatment should 
be curetted or a portion of the affected skin removed with 

the knife. 

Gangrenous dermatitis usually appears as a stationary 
disease in certain localities. It has also been known to appear 
in epidemic form. 

Cause — Such causes as cold, moisture, filth, snow, etc., 
seem to predispose to this disease. 

Symptoms — This disease makes itself manifest by a very 
painful swelling, lameness, and such general symptoms as 
fever and dullness. In the center of this swelling there are 
well marked gangrenous areas, which are discolored. After 
several days these small gangrenous areas of skin slough off, 
leaving an ulcerating surface behind. This condition usually 
heals by granulation and cicatrization in from two to three 
weeks. If this disease becomes quite severe it may lead to 
the formation of a quittor by the necrosis spreading to the 
lateral cartilage of the foot. 

Prognosis — If the disease remains uncomplicated the 
prognosis is quite favorable. 

Treatment — The treatment consists in disinfection by 
means of frequent irrigation, of antiseptic solutions or warm 
moist antiseptic bandages. Necrotic areas should be removed 
with a knife and ulcerating surfaces should be cauterized or 
painted with equal parts of tincture of iodine and aloes. 

Foot Rot in Sheep and Cattle. 

This consists in a chronic exanthema of the skin below 
the carpus and tarsus, and occurring mainly in the region of 
the coronary band. 



The Practice of Veterinary Surgery 115 

Cause — The exact cause of this condition is unknown, 
but it is supposed to be due to a specific infection. 

Symptoms — This disease appears as a painful erythema 
of the skin, then vesicles form, and later on pustules. These 
pustules discharge, leaving behind ulcerating surfaces which 
suppurate for months. This ulcerating surface frequently 
becomes very large and is accompanied by septic phlegmon, 
septicaemia and death. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in cleanliness, new 
location, good wholesome food, creolin ointment, creolin and 
alcohol, or any antiseptic. 

Fracture of the First Phalanx. 

The cause of fracture of the os suflfraginis or first phalanx 
is usually due to some injury. The fracture may be complete, 
incomplete, simple, compound or fissured. Fissures as a rule 
are longitudinal, and appear more often near the upper por- 
tion of the bone. 

Symptoms — The symptoms consist in the sudden appear- 
ance of a very high grade lameness, causing the animal to 
walk on three legs. At the point of fracture there is crepita- 
tion, swelling, heat, pain, and the leg shows abnormal 
movements on manipulation. The symptoms of a fissure are 
more obscure and harder to recognize. In a fissure there is 
also the appearance of a very suddenly appearing high grade 
lameness, but there is no abnormal movement present, ^y 
careful palpation a pain line may be located which shows the 
presence of a fissure. In a fissure the symptoms of a very 
high grade lameness may last for months. 

Prognosis — The prognosis of a fracture of the os sufifra- 
ginis is as follows : Compound, comminuted and splintered 



ii6 The Practice of Veterinary Surgery 

fractures are usually considered to be incurable. If the animal 
does recover it is usually left in a helpless or worthless con- 
dition. Fissures and simple fractures usually heal after about 
three months, leaving the animal practically as good for 
service as ever, but may lead to exostosis, or this bone may 
unite with the second phalanx. 

Treatment — The treatment consists in applying a cast, 
bandages, rest and slings. If there should be lameness 
remaining as the result of exostosis, neurectomy should be 
resorted to. 

Periostitis on the Dorsal Surface of the Os Suffraginis. 

In some horses a periostitis with exostosis formation on 
the dorsal surface of the os suffraginis is seen quite frequently. 
This exostosis most commonly appears on the upper third or 
the middle of the bone. 

Cause — The causative factors of this trouble are distor- 
tion, mis-stepping, running into foreign objects, etc. 

Symptoms — The symptoms are a severe lameness which 
arises very suddenly. When the animal is standing the leg 
is held in the position of volar flexion. This lameness becomes 
more severe on hard roads and less severe on soft roads. By 
manipulating the leg it usually appears that this causes some 
pain. On the bone there will be noticed an exostosis, which 
may show acute inflammatory symptoms, as heat and pain. 
This exostosis in the earlier stages is about the consistency 
of cartilage, later becoming hard and painless. This condition 
is commonly known as high ring-bone. 

This condition is often confused with fissure. In fissure 
the lameness would not exist more than four months and the 
thickening would be diffuse, that is, all around the bone. In 
fissure there may be a chronic lameness left behind. The 



The Practice of Veterinary Surgery 117 

lameness of periostitis will not last longer than six weeks if 
properly treated. 

Treatment — The treatment of this condition in the acute 
stages consists of Priesnitz packs, rest and irritating liniments. 
After the acute stages pass off, blistering and firing should 
be resorted to. As this condition occurs in young animals 
mainly, calcium phosphate, or potassium iodide, should be 
given internally. 

Osteomyelitis of the Os Suffraginis. 

A primary infectious osteomyelitis of this bone is the 
result of the entrance of the pus cocci or other pathogenic 
micro-organisms into the marrow of the bone from the blood 
stream. The supposition is that the pathogenic organisms 
enter the blood stream through a phlegmon, gangrene or an 
inflammation of the skin. Distortions or mechanical injuries 
seem to be predisposing factors toward the cause of the 
entrance of the micro-organisms. In compound fracture 
there is a suppurative osteomyelitis as the result of direct 
infection. 

Symptoms — The symptoms of this condition consist in 
a suddenly appearing high grade lameness, followed by diffuse 
swelling around the bone, which is firm and almost painless. 
Later on there is the formation of bone and this swelling 
becomes more hard and osseus. After several months there 
will form circumscribed, fluctuating areas, abscess formation 
and fistula. 

Prognosis — The prognosis of this condition is unfavor- 
able, as the animal usually dies from septicaemia. 

Treatment — The treatment consists in treating the symp- 
toms as they arise. 



ii8 The Practice of Veterinary Surgery- 



Diseases of the Coronary Band. 

Punctured wounds of the coronary band may be looked 
upon seriously, especially calk wounds, as they are very 
frequently followed by tetanus, suppurative arthritis or 
phlegmon. Deep wounds of the coronary band are followed 
by sub-coronary phlegmon, quittor, necrosis of the sensitive 
laminae, keloids and suppurative inflammation of the coronary 
band. The horn itself as the result of any of these conditions 
will split, crack or separate from the sensitive laminae form- 
ing the so-called hollow wall. 

Treatment — The treatment of these wounds should be 
carried out under the most careful precautions. Injections 
of iodoform ether or tincture of iodine should be used very 
freely. 

Sub-Coronary Phlegmon, 

Sub-coronary phlegmon consists in a suppurative inflam- 
mation of the subcutaneous connective tissue under the coro- 
nary band. If a sub-coronary phlegmon appears in the region 
of the lateral cartilage it is known as parachondral phlegmon. 

Cause — The causes of sub-coronary phlegmon are punc- 
tured wounds, suppurative or necrotic inflammation of the 
laminae, suppurative podotrochlitis or arthritis. This disease 
very rarely appears primarily, but usually follows or is due 
to some other disease. 

Symptoms — The symptoms of sub-coronary phlegmon 
consist mainly in a circumscribed (rarely diffuse) inflam- 
matory swelling in the region of the coronary band. This 
swelling is hot, painful, fluctuating in given areas, and gives 
rise to a very severe lameness. Acute cases heal at this point 
without suppuration, while chronic cases lead to abscess 
formation in one or more places, and as a result of this abscess 



The Practice of Veterinary Surgery 119 

formation fistulae are formed which involve the cartilage, 
tendon or bone. In some cases there is an absorption of this 
septic material causing the animal to die from septicaemia. 
After complete healing, there is usually a chronic thickening 
present, which leads to deformity of the hoof. 

Differential Diagnosis — The differential diagnosis is acute 
S'erous arthritis. The swelling in arthritis is evenly distributed 
around the entire region, while sub-coronary phlegmon ap- 
pears circumscribed. It is a very dangerous proceeding to 
incise an. acute arthritis. 

Prognosis — The prognosis of sub-coronary phlegmon is 
as follows : Acute cases usually recover without any further 
trouble. The prognosis of chronic cases is less favorable, as 
it leads to complications. 

Treatment — The treatment of the acute cases consists in 
hot packs containing some antiseptic solution or some mild 
astringent lotion. Abscesses should be incised and treated 
accordingly ; ulceration and fistula formation should be treated 
with caustics or by operative means. 

Distortion of the Coffin Joint. 

This disease is very rare, but occurs among horses as the 
result of faulty position from shoeing or mis-stepping. 

Symptoms — The symptoms are very suddenly appearing 
high grade lameness, swelling around the coronet, great pain 
shown on passive motion, especially by rotating the foot. 
This may be looked upon as a diagnostic symptom. 

Course — The course of this condition varies greatly. 
Most cases recover in a short period of time. 

Prognosis — The prognosis of these cases is quite variable 
and should be made with great care, on account of the many 



I20 The Practice of Veterinary Surgery 

complications which may arise from it, as ring-bone, arthritis 
or an incurable lameness may be left behind. 

Treatment — The treatment consists in rest, moist heat 
and massage in the earliest stages ; in the later stages plaster 
casts, firing, blistering and neurectomy may be resorted to. 

Ring-Bone. 

This condition consists in a chronic aseptic inflammatory 
process accompanied by osseus formation in the region of 
the first phalanx. From a clinical standpoint, there are two 
forms of ring-bone; these are articular and peri-articular. If 
the joint surfaces become involved in the form of a chronic 
deforming arthritis, it is known as an articular ring bone. 
If this process is merely an exostosis, not involving the joint 
capsule, in the form of a periostitis ossificans, it is known as 
peri-articular ring-bone. This last form usually appears in 
the region of the attachment of the suspensory ligament. 

Cause — The causative factors of ring-bone may be from 
external or internal sources. The internal or pre-disposing 
factors consist in an abnormal position of the leg causing an 
unevenness of pressure from side to side, small weak joints 
and bones, or faulty shoeing in which the foot is not level. 
The external or immediate causes are over-exertion in young 
horses, distortion, ostitis, fissures, fractures, and traumatisms. 

Symptoms — The symptoms of ring-bone are lameness, 
which is either constant or becomes worse on exercise, and 
seems to become more severe on hard roads. The front legs 
are generally afifected with this condition. The lameness 
seems to be mixed, but in very chronic cases is supporting 
leg lameness. When the animal is at rest the affected foot 
is usually held extended. As a result of this disease, the 
shoulder or croup muscles become very atrophic. By rotating 



The Practice of Veterinary Surgery 121 

the joint, great pain is shown. The most important symptom 
is a large, hard, painless exostosis in the region of the coro- 
nary band. In articular ring-bone this exostosis is quite 
large and extends entire!}^ around the joint, while in peri- 
articular ring-bone this exostosis is somewhat larger on the 
sides of the bone, or may appear only on one side. As a 
very general rule the articular form leads to anchylosis with 
a resulting mechanical lameness. A so-called "blind ring- 
bone" may appear as the result of a chronic deforming 
arthritis without exostosis. 

From an anatomical standpoint this exostosis may be 
dorsal, volar, lateral, partial, plantar, or circular. In the be- 
ginning of this disease this exostosis appears as a fibrous 
vascular swelling about the consistency of cartilage. Later 
on these become osseus and very hard. On inspection these 
exostoses appear as rough protuberances, resembling pumice 
stone. On cross section, the periostium is found to be thick- 
ened, the sub-chondral bony structure is found to contain 
dark red cavities, filled with soft, gelatinous material. The 
structure of this bone resembles rarifying ostitis. Later on 
in the disease the gelatinous material is found to be hard and 
of the consistency of bone. In articular ring-bone, the joint 
surface is dull, rough, covered with small exostosis and very 
uneven. The rarifying ostitis usually begins On the edge of 
the cartilage and from there extends to the center. The 
capsular ligament and the tendons in this region are thick- 
ened and in some cases partially ossified. 

Prognosis — The prognosis of articular ring-bone, espe- 
cially if in the form of a chronic deforming arthritis, is always 
looked upon as grave and the prognosis is unfavorable. Even 
in cases of complete anchylosis there is so much mechanical 
lameness as to render the animal worthless. 

The prognosis of peri-articular ring-bone is quite favor- 
able in all cases. These cases usually yield to treatment 

9 



122 The Practice of Veterinary Surgery 

without any further inconvenience. In a great many of these 
cases, simply a balancing and level shoeing is all that is 
required to have complete healing. 

Treatment — The treatment of articular ring-bone consists 
in blistering, followed by a long period of rest, firing, and 
eventually neurectomy. The results in all cases are quite 
variable. 

The treatment of peri-articular ring-bone consists in rest, 
blistering agents and eventually firing. Neurectomy need not 
be resorted to only in most severe cases. In this form of 
ring-bone there may be a very large exostosis, but these very 
rarely give rise to any lameness whatever. 

Fracture of the Second Phalanx. 

As in all other fractures the cause of this is usually due 
to some mechanical injury. These fractures as a very general 
rule are multiple, that is, the bone is in a number of pieces. 

S3anptoms — The symptoms of this condition are a very 
suddenly appearing high grade lameness ; around the coronary 
band there is a large, painful swelling; on passive movement 
there is great pain and crepitation may be felt. There seems 
to be great freedom of movement of the hoof, and this may 
be looked upon as the diagnostic symptom. 

Prognosis — The prognosis of this condition may be 
looked upon as unfavorable on account of the complications 
which follow it. Even if the bone should heal, there would 
be left behind a chronic incurable lameness, which could only 
be relieved by neurectomy. This condition usually leads to 
ankylosis, the formation of a ring-bone, exostosis formation 
with contraction of the tendons forming a so-called stiltfoot. 

Treatment — The treatment consists in casts, slinging, rest 
and eventually neurectomy. 



The Practice of Veterinary Surgery 123 

Podoarthritis. 

Podoarthritis appears in three forms in practice. These 
are suppurative, acute aseptic and chronic deforming arthritis. 

Suppurative podoarthritis appears most commonly as the 
result of a direct infection from nail puncture or tread on 
the coronary band involving the joint. It may also occur as 
the result of the spread of a suppurative inflammatory process 
as phlegmon, quittor or fracture of the os pedis. 

Symptoms — The symptoms of this condition are the 
exudation of pus and synovia from the wound. On passing 
the probe, the cavity can often be explored. There is a circum- 
scribed, painful swelling around the coronary band, the animal 
shows severe lameness and severe pain on passive movement. 
There are such general symptoms as elevation of tempera- 
ture, chills and dullness and symptoms of septicaemia and 
pyaemia. 

Prognosis — The prognosis of this disease is unfavorable ; 
as a general rule death is the result. 

Treatment — The treatment consists in antiseptic baths, 
soaking the foot for hours in warm antiseptic solutions. 
Make free incisions for drainage and inject iodoform ether 
into the wound along with the subcutaneous injection of 
autogenous or polyvalent bacterins. In cases of recovery 
ankylosis usually takes place in from four to six weeks. 

Acute aseptic podoarthritis is either serous or sero- 
fibrinous in character. It is generally the result of distortion, 
tread on the coronet without puncture of the coronary band, 
over-exertion, following the operative treatment of quittor, etc. 

Symptoms — The symptoms consist in a suddenly appear- 
ing high grade lameness, with severe, painful swelling of the 



124 The Practice of Veterinary Surgery 

coronary band. There is considerable pain evinced by passive 
movements. This disease usually heals very promptly with- 
out any after effects, but may lead to chronic deforming 
arthritis. 

Treatment — The treatment in the first stages consists in 
moist heat, rest, massage and liniments. In cases of chronic 
lameness neurectomy should be resorted to. 

Chronic deforming arthritis of this joint is usually due 
to distortion, tread on the coronet, faulty shoeing, over- 
exertion, etc. 

Symptoms — The symptoms of this condition are prac- 
tically the same as those of ring-bone, without a severe 
exostosis formation. There are two forms, articular and peri- 
articular. This condition gives rise to a chronic lameness, 
which will usually disappear after a diagnostic cocaine injec- 
tion. After this disease has been standing for some little 
time, there is a severe atrophy of the entire foot. 

Prognosis — The prognosis of this condition is usually 
quite unfavorable and the course is chronic. . 

Treatment — The treatment consists in neurectomy. 

Podotrochlitis. 

This is an inflammation of the bursa podotrochlearis 
primarily, which later on involves the navicular joint. The 
chronic aseptic form of this disease is commonly known as 
"navicular disease." In practice two forms are diagnosable ; 
they are the acute suppurative, traumatic podotrochlitis, 
which is seen as the result of nail puncture, and chronic 
aseptic podotrochlitis. 

Cause — Acute suppurative podotrochlitis usually follows 
nail puncture, which enters the navicular bursa. 



The Practice of Veterinary Surgery 125 

Symptoms — This is characterized by a high grade lame- 
ness, phlegmon of the fatty frog and the heels and great pain 
on excessive dorsal flexion. This form usually leads to a 
necrosis of the tendons with abscess formation in the region 
of the heel. 

Prognosis — The prognosis is generally favorable. 

Treatment — The treatment consists in resection of the 
perforans tendon and bursa, with antiseptic treatment fol- 
lowing. . 

The most satisfactory method of resecting the perforans 
tendon is as follows : After anaesthetising the animal and 
thoroughly cleansing the field of operation, remove the horny 
frog in toto, followed by removal of the fatty frog over the 
bursa and perforans tendon. After the tendon is exposed 
remove that portion that is necrotic and detach from its 
attachment, thoroughly cleanse and remove any other necrotic 
areas, fill the wound with iodoform, pack and apply an 
occlusive bandage. This bandage should be left in position 
for at least ten days. Healing usually takes place without 
any further complications. 

Chronic aseptic podotrochlitis or navicular disease con- 
sists in a chronic deforming inflammatory condition in the 
region of the navicular bone. This condition usually exists 
in the front feet and in certain breeds. 

Cause — Short, stumpy feet that are dry and hard seem 
predisposed to this disease. This condition may appear in 
one or both front feet. The cause is supposed to be continual 
over-exertion, faulty shoeing and faulty position. In the 
beginning of this disease the lesion is located in the bursa; 
from here it spreads to the navicular bone, and later on the 
tendon. Early in the course of the disease the tendon is 
slightly lacerated; later on it undergoes a partial ossification 
and becomes adherent to the navicular bone. The tendon 



126 The Practice of Veterinary Surgery 

has been known to rupture in severe cases. The cartilage 
undergoes ulceration while the bone undergoes ostitis, fol- 
lowed by osteoporosis and exostosis formation. 

Symptoms — The symptoms of navicular disease do not 
appear suddenly, but come on graduall}^ during a period of 
several months. At first the animal is noticed to be limping, 
which is very slight but gradually becomes quite severe. In 
breaking over, the animal is noticed to show great pain, and 
this act is performed very rapidl)^ owing to this fact, causing 
the animal to have a short, choppy gait. This lameness 
becomes much more severe on hard roads and less severe on 
soft roads and plowed ground. The lameness becomes more 
severe after being driven a long period of time ; also becomes 
more severe when shod with a bar shoe or a high toe calk. 
The lameness seems to be irregular ; at times it is worse and 
at other times will almost disappear on exercise. By 
manually forcing the bulbs together the animal will show 
great pain ; if the toe is placed higher than the heels the 
animal will show great pain also. After this disease has run 
a course of months the foot and shoulder muscles become 
very atrophic. This disease is most easily diagnosed by a 
cocaine injection, when all other symptoms are negative. 

Prognosis — The prognosis is quite unfavorable; most 
cases are incurable. 

Treatment — The only treatment for this condition is 
neurectomy of the plantar or median nerves. Before perform- 
ing neurectomy the feet should be softened and treated so 
that they are in a perfectly healthy condition. 

Suppurative Inflammation and Necrosis of the Third Phalanx 
and the Navicular Bone. 

A suppurative periostitis and ostitis of these bones is not 
so uncommon in practice as the result of neurectomy, frac- 



The Practice of Veterinary Surgery 127 

ture, nail puncture and tread on the coronary band (calking). 
It may also occur as the result of a suppurative pododer- 
matitis and podotrochlitis spreading and infecting to these 
parts. A phlegmonous inflammation of the foot may also 
give rise to this condition. 

Prognosis — The prognosis is unfavorable. 

Treatment — The treatment consists in free incisions, 
curetting, and antiseptic irrigation and soaking the foot for 
a long 4)eriod of time in a warm antiseptic solution. 



CHAPTER IV 

DISEASES OF THE THORAX AND ABDOMEN 

Wounds. 

WOUNDING of the breast is quite common in horses 
and is usually the result of accidental injuries such 
as being- kicked, run over, or rolling on sharp ob- 
jects. These wounds may be superficial, deep or penetrating. 
Bruising or contusions in this region very often lead to 
phlegmon w^ith abscess formation. If some of the larger 
vessels are involved there may be the formation of a hema- 
toma, hemorrhage, suppurative trombo-phlebitis or hemato- 
thorax. A contusion of the musculature leads to lameness, 
intermuscular phlegmon, abscess formation, and in rare cases 
fistula formation. A contusion of the bone may lead to frac- 
ture, fissure, necrosis and fistula formation. There may be 
contusions of the large nerve trunks leading to paralysis. 
Perforating" wounds of the thorax may give rise to pleuritis, 
pneumonia and pneumo-thorax. , 

Treatment — The treatment consists in the arrest of the 
hemorrhage, drainage and antiseptic irrigation for contusions, 
or Priesnitz packs and liniments. It very seldom occurs that 
this class of wounds need to be sutured. 

Wounding of the thoracic wall may be quite common 
from accidental injuries. These wounds are classified as 
perforating and non-perforating. The non-perforating wounds 
involve the skin, subcutis and bone. These may lead to 
various wound infectious diseases, as phlegmon, malignant 
oedema, etc., or fractures, abscess formation and fistula. The 



The Practice of Veterinary Surgery 129 

perforating wounds lead to pleuritis, collapse of the lung, 
pneumonia, pneumo-thorax, hemato-thorax and internal hem- 
orrhage as the result of the rupturing of a large artery. 

Treatment — The treatment consists of sponging or irri- 
gating with astringent antiseptics. The probe should never 
be used in these wounds, to determine the depth and position, 
as this may lead to a perforation. If the wounds are ragged 
and deep, a few drachms of iodoform ether should be injected 
into the wound, twice or three times daily. If the wounds 
are quite superficial they may be dressed with the ordinary 
dusting powders. 

In cases of empyema of the thoracic cavity, the wound 
should be made large enough to have complete drainage. 
Then the entire cavity should be irrigated with mild anti- 
septic solutions, as potassium permanganate, sodium bicar- 
bonate, boric acid, etc. 

Rupture of the Seratus Magnus. 

Rupture of the seratus magnus is seen in the horse and 
usually occurs in runners. 

Symptoms — The symptoms consist in a sitiking of the 
body between the shoulder blades. The shoulder blade in 
some cases will extend four to six inches above the spines 
of the dorsal vertebrae. 

Prognosis — The prognosis is as a whole unfavorable. 

Treatment — The treatment is almost worthless and if the 
animal is not very valuable it might better be destroyed. 
Very valuable animals may be treated in the following way : 
A sling belt should be used that will reach from the point 
of the sternum to the hind flank. In this there should be 
some openings, which will allow the front legs to pass through 
the belt. Then the animal must be slung in this, and all of 



130 The Practice of Veterinary Surgery 

the weight of the trunk must be removed from the limbs. 
The legs will fall into proper position and healing takes place 
in about three weeks. 

Shoulder Abscesses. 

This condition is nearly always seen in draft horses as 
the result of an injury by pressure from the collar, and in 
running horses as the result of an injury due to violent 
exercise. A so-called cold abscess has reference to an encap- 
sulated muscle abscess in the mastoido-humeralis muscle, 
while a chronic suppurative myositis is the most common 
form seen in practice. 

Cause — This is caused partly by pus cocci and partly by 
botryomyces fungi. About twenty per cent of these abscesses 
are due to botryomycotic infection. This infection is carried 
into the tissues through skin wounds. After passing through 
the skin these bacteria are taken up by the lymph stream 
and carried to the intermuscular lymph glands and from 
there to deeper lymph glands (axillary glands). 

A subcutaneous abscess due to a circumscribed phlegmon 
may appear under the same symptoms as a so-called cold 
abscess. In rare cases tumefactions may appear under the 
same symptoms as a cold abscess. A suppurative lymph- 
adenitis or a tubercular lymph-adenitis may be mistaken for 
a cold abscess. 

Symptoms — The symptoms of a cold abscess begin with 
the appearance of a tumefaction at the point of the shoulder. 
This tumefaction is cold and almost painless. After weeks 
and months of development it may attain the size of two 
fists. The skin becomes attached to the tumefaction in its 
center and is movable over the rest of it. The skin also 
becomes firm in consistency and thickened. In rare cases it 
shows a tendency to become necrotic. These tumefactions 



The Practice of Veterinary Surgery 131 

as a rule are not movable in the tissues, but in rare cases 
may show a tendency to move. On palpation it appears that 
these tumefactions have become attached to the mastoido- 
humeralis muscle. These abscesses are generally firm in con- 
sistency and very rarely have a fluctuating spot on the 
surface. In some cases it has been noticed that these abscesses 
have a tendency to undergo calcification and on palpation a 
firm object may be felt, v^hich will resemble a foreign body. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment of this condition consists in 
incising as soon as possible and evacuating the contents. A 
long incision should be made in a downward direction the 
full length of the tumefaction. This incision must be deep 
enough to thoroughly open and drain the abscess. If neces- 
sary some of the musculature should be removed from the 
sides of the wound to allow drainage and treatment. The 
capsule should be curetted, scraped or excised, and then the 
entire wound treated as an open wound, with antiseptic 
irrigation and dusting powders. These wounds usually dis- 
charge copiously and heal after about one month. 

SHOULDER FISTULA. 

Fistula of the Withers. 

This condition is brought about by an injury, usually by 
rolling or rubbing of the saddle or harness. This injury 
involves the skin, subcutis and musculature in the region of 
the withers. Severe injuries also involve the fascia, synovial 
bursa, vertebral processes, the scapula and cartilage of pro- 
longation. If the lesion is in the skin it is usually due to 
contusions of the first and third grades with a resulting 
hemorrhagic infiltration and inflammation. If the lesion is 
in the subcutis it is nearly always due to contusions of the 



I3« The Practice of Veterinary Surgery 

second grade with a resulting hematoma formation, bloody- 
suffusion or an extravasation of lymph. Aseptic cases of this 
kind lead to encapsulation and organization of the hematoma. 
Cases that become infected lead to subcutaneous phlegmon 
and necrosis of the subcutaneous connective tissue. If the 
lesion is in the musculature or the fascia, it consists in a 
bloody suffusion, and if infected may lead to inter-muscular 
or subfascial phlegmon with necrosis of the fascia and muscles. 
The synovial bursa, if injured, may show such changes as 
acute bursitis or chronic hydrops; if it becomes infected it 
will lead to a suppurative inflammation. The processes of 
the vertebras as the result of this suppurative inHammation 
usually undergo necrotic changes. 

Cause — The causes of this disease may be predisposing 
and immediate. The predisposing causes are those of high 
prominent withers, or the angle of the shoulder may be too 
straight or very oblique. An abnormally thick and heavy 
shoulder seems to be most commonly affected. The imme- 
diate causes are those of injuries and contusions of various 
grades. The collar may be at fault or the animal may roll 
on a foreign body, or be cast in a narrow stall, etc. 

Symptoms — The symptoms are made manifest by the 
appearance of a tumefaction apparently due to a contusion. 
This usually comes on very suddenly, that is, from two to 
three hours after the injury. This tumefaction is either 
cutaneous (that is, sharply defined and hard), or subcutane- 
ous (that is, the swelling is diffuse, soft and often fluctuating, 
especially if there is a hematoma). A hematoma is cold and 
painless, while a phlegmonous swelling is hot and painful. 
The infection causes either a subcutaneous, intermuscular 
subfacial phlegmon or suppurative bursitis and dermatitis. 
A true fistula in this region is a subfascial phlegmon. The 
skin in this region is usually swollen and shows cutaneous 
lymphangitis. Next we find the appearance of a fistulous 



The Practice of Veterinary Surgery 133 

canal, at the base of which there are soft, discolored granu- 
lations. In some cases there is gravitation of pus between 
the scapula and the vertebrae. In other cases there may be 
a septic phlegmon produced which will cause a fatal sep- 
ticaemia. When this disease assumes a chronic form there 
are usually one or more small fistulous openings, which dis- 
charge a greenish pus profusely. These openings are small 
and round, with smooth edges, and the canal or tract which 
they expose is also smooth and well defined. The surround- 
ing tissue usually becomes indurated, swollen and slightly 
painful. ' There is considerable pain shown when great 
pressure is exerted on the part. 

In the aseptic form resolution usually takes place quite 
readily. In infected cases there is either encapsulation with 
organization or abscess formation and necrosis. This latter 
may lead to phlegmon, abscesses, necrosis of the musculature, 
the fascia, and the bones as well as septicaemia. 

Prognosis — The prognosis is usually quite favorable in 
aseptic cases, and unfavorable in the cases that become 
infected, especially if there is a tendency to necrosis. 

Treatment — The treatment of the asceptic form consists 
in massage, moist heat, counter irritation antt eventually 
strong blisters. Cases of encapsulated hematomas or hygro- 
mas should be punctured or incised under strict aseptic 
precautions. It is usually advisable not to incise this form 
until everything possible has been given a fair trial so that 
a positive diagnosis can be made. 

The treatment of the suppurative form consists in incising 
as early as possible. These incisions should be made long 
and deep and all necrotic areas carefully removed. The 
wound must have perfect drainage and then be irrigated with 
astringent antiseptics and covered with a dusting powder. 
These cases do not yield to treatment readily and it is gen- 
erally advisable to use escharotics. These are slower in 



134 '^^^ Practice of Veterinary Surgery 

action and in most cases give more satisfactory results. If 
after using escharotic paste the wound does not granulate 
properly it should be painted with five per cent solution of 
zinc chloride or equal parts of tincture of iodine and carbolic 
acid. Along with this bacterins should be used. 

It is very rarely advisable to pack these wounds, but 
they should be treated as open wounds and be allowed to 
heal by second intention. Such escharotics as zinc chloride, 
arsenic and sanguinaria are used most commonly in these 
cases. 

Fracture of the Ribs. 

Fractured ribs are seen most commonly in horses, less 
often in cattle and dogs. These fractures are mostly .simple 
or fissured, but may be periosteal, green stick and compound. 
Usually in practice several ribs are found to be fractured. 

Cause — The cause of fracture of the ribs is usually some 
injury from the outside, but such diseases as osteomalacea, 
rachitis, sarcomas, tuberculosis, actinomycosis or glanders 
lesions affecting the bone seem to be predisposing factors. 

Symptoms — The symptoms of fractured ribs differ greatly. 
A great many cases are not diagnosed and heal without 
showing any noticeable symptom. (These cases are seen 
only on post mortem.) A fracture can usually be detected 
by a local swelling which is circumscribed and painful; in 
some cases crepitation can be felt, but this is not constant. 
If the fractured rib has punctured the pleura or the lung 
there are symptoms of pleuritis, pneumonia, hemorrhage, 
subcutaneous emphysema, and in rare cases pneumo-thorax. 
A fractured rib may wound the diaphragm, peritoneum, 
stomach, bowels, liver and spleen. It may also lead to a 
fatal internal hemorrhage as a result of rupturing one or more 
of the costal arteries, the heart or the internal thoracic artery. 
A compound fracture will generally lead to the formation of 



The Practice of Veterinary Surgery 135 

a fistula. A fracture of the first ribs may lead to severe lame- 
ness and show no other symptom. 

Prognosis — The prognosis is favorable if uncomplicated. 

Treatment — The treatment is to keep the animal as quiet 
as possible in simple fractures. In compound fractures the 
wound must be treated antiseptically. In case the healing 
will form a very large callus and be unsightly, it may be 
painted with tincture of iodine and massaged. 



Fistula of the Ribs. 

The most common cause of this is compound fractures 
in which there is necrosis of a small piece of bone, with the 
formation of a sequestrum which becomes encapsulated. It 
may also occur from suppurative phlegmon and shoulder 
fistula in which there is gravitation of pus. This gravitation 
of pus attacks the periosteum, and then the bone, leading 
eventually to the formation of a fistula. This condition has 
been known to occur by metastasis in such diseases as glan- 
ders, distemper, actinomycosis and tuberculosis. 

Symptoms — The symptoms of fistula of the ribs are made 
manifest by a small round opening which discharges pus 
persistently. This opening is constructed with very smooth 
and hard edges. The surrounding tissue is usually swollen 
a little, but not very severely. By passing the probe into 
the fistulous canal a sequestrum of bone can usually be felt. 

Treatment — The treatment consists in curettement and 
antiseptic irrigation. In case of sequestration, remove the 
necrotic area and give the wound good drainage. If the 
fistula has been of long standing it may be necessary to remove 
the periosteum and curette the bone or resect a portion of 
the rib. 



136 The Practice of Veterinary Surgery 



Sternal Fistula. 

This condition is seen mostly in the horse and consists 
in a necrotic chondritis with sequestrum formation of parts 
of the sternum. This leads to the formation of a fistula, with 
a sclerosis of the subcutaneous, periostial and intermuscular 
connective tissue. This condition is usually the result of 
contusions but has been known to occur by metastasis in 
glanders. 

Symptoms — The symptoms are the appearance of a 
fistulous opening on the sternum, which constantly discharges 
more or less pus or necrotic material. The surrounding tissue 
is very hard to the touch. In severe cases of long standing 
the animal becomes more or less emaciated. In rare cases 
it may cause a slight lameness. These fistulous canals are 
usually of great length. 

Treatment — The treatment consists in giving good drain- 
age, antiseptic irrigation and removal of all necrotic areas. 
This is most easily accomplished by the use of escharotic 
paste. The sclerotic portion surrounding the fistulous canal 
must also be removed the entire length of the canal. If 
healing is retarded, tincture of iodine or a five per cent 
solution of silver nitrate may be used. After removal of the 
necrotic areas and sclerotic portion it may be treated as an 
open wound. 

DISEASES OF THE ABDOMEN. 
Wounds. 

Superficial wounds in this region are generally the result 
of contusions, and involve the skin, subcutaneous tissue and 
the superficial musculature. These wounds are mostly punc- 
tures, contusions and tearing of the skin. They may also 



The Practice of Veterinary Surgery 137 

be due to bites. The most common wound infection disease 
seen here is phlegmon. This is either subcutaneous or inter- 
muscular which has a tendency to become necrotic. This 
condition consists in a profuse swelling, which is hot and 
painful and has a tendency to abscess formation. In rare 
cases this may undergo resolution. It very often happens 
that we find very large encapsulated abscesses on the 
abdomen, which are very similar to those seen in the region 
of the shoulder. Fistula, suppurative peritonitis or septic 
phlegmon do not appear commonly in this region, but if they 
do appear they lead to death very rapidly. 

A contusion in this region usually leads to a bloody 
effusion, a hematoma or the rupture of a muscle, with a 
resulting hernia. This form of hernia, which is seen as the 
result of muscle rupture, usually becomes encarcerated and 
leads to death. 

Treatment — The treatment of these superficial wounds 
consists in stitching the skin if necessary, remove all ragged 
edges around the wound, give good drainage and irrigate with 
some astringent antiseptic. Phlegmons should be treated 
with moist heat, Priesnitz packs, antiphlogistine, camphor 
ointment, etc. If this phlegmon becomes chronic apply 
blisters or paint the surface with tincture of iodine. Abscesses 
must be incised. This should be done most carefully, as a 
deep incision may lead to a hernia. A probe point bistuory 
and guide probe should be used in opening a hematoma or 
abscess in the region of the abdomen. 

Perforating Abdominal Wounds, 

These wounds are divided into two classes : Those allow- 
ing the mesentery and viscera to protrude, and those which 
do not. 

A simple wounding or injury to the peritoneum is not a 
serious thing, unless there is some infection carried into the 



138 The Practice of Veterinary Surgery 

wound. The peritoneum of horses seems to be most sus- 
ceptible to infection of various kinds. The peritoneum of 
other animals does not seem to be so susceptible, while the 
peritoneum of the dog is the least susceptible. There are 
some common operations in practice which involve the 
peritoneum, as castration, both ordinary and cryptorchid, 
laparotomy for various causes, and puncture of the viscera in 
flatulency. Ordinarily these operations are carried out under 
strict asepsis, and there are no bad results following, but 
perforating wounds with infection are always serious and the 
prognosis is always grave. Perforating wounds with infec- 
tion usually lead to peritonitis. 

Treatment — The treatment of these wounds is careful 
washing with disinfectants and suturing. Iodoform ether 
should be used in these cases, very freely before suturing. 
If the wound is in the form of a contusion, and there is some 
danger of a muscle rupture with hernia, a stout bandage or 
truss should be applied over the region affected, after the 
wound has been covered with ariol paste or gauze to prevent 
the entrance of infection. 

Perforating abdominal wounds with a prolapse of 
omentum or mesentery are not always so grave as might be 
thought. The supposition is that the prolapsed portion fills 
the wound and seals it, keeping out all infection. 

Treatment — In treating these wounds the prolapsed 
omentum should never be returned, but should be drawn out 
a little and removed with a pair of scissors as far up as 
possible. Great care should be exercised so as not to allow 
the infected portion of it to be taken back into the abdomen, 
as this may lead to infection. This should be done only after 
the most antiseptic precautions have been exercised. The 
wound should be cleansed first, then iodoform ether applied, 
and finally the skin wound may be sutured and covered with 
ariol paste. In some cases these wounds are so large that 



The Practice of Veterinary Surgery 139 

it may become necessary to pack them with gauze before 
suturing. In cases of prolapse of the omentum following 
castration the prolapsed portion must be removed and not 
returned. 

Perforating abdominal wounds with a prolapse of the 
viscera is always a serious matter. The prognosis should 
always be made with care. 

Cause — This condition is brought on by such operations 
as cryptorchid castration, ordinary castration, spaying mares 
through the vagina and spaying bitches. In this latter case 
it is usually the result of improper suturing, and as a result 
the stitches tear out, allowing the viscera to prolapse. The 
animals affected will usually injure the viscera by treading 
on it, biting it and dropping on the ground. This leads to 
gangrene of the prolapsed part and allows the infection to 
enter the abdominal cavity. 

Treatment — In treating these cases great care must be 
taken to have everything perfectly aseptic and clean. If the 
viscera has come in contact with the ground, or if gangrene 
is present, the case is hopeless and reposition is of no avail. 

Intestinal Fistula. • 

This designates an opening of the lumen of the bowel 
which connects itself with the skin, causing the lumen of the 
bowel to be communicated with the external air. This fistula 
constantly discharges pus and intestinal contents. There is 
generally more or less adhesive peritonitis in the region sur- 
rounding the opening, which causes the wall of the intestine 
to become adherent to the abdominal wall. 

Cause — This condition is most commonly caused as a 
result of puncturing with a filthy trochar, but may be due 
to perforating wounds of any kind, perforation of the lumen 



140 The Practice of Veterinary Surgery 

of the bowel by foreign bodies in the intestinal tract, necrosis 
in hernias or as a result of ovariotomy. 

Treatment — The treatment of this condition consists in 
cauterization, curetting and draining the fistulous tract. This 
should be followed by astringent antiseptic washes. 

In the ox there is frequently found a fistulous tract con- 
necting the reticulum with the skin. This results from a 
sharp object in the reticulum pushing its way outward and 
as a result causing a fistula to form. This condition is also 
known as a "cold abscess" and is treated in the same manner 
as intestinal fistula. 

Umbilical Hernia. 

This condition is seen most commonly in horses and 
dogs. There is usually a rent in the abdominal floor in the 
region of the umbilicus, causing the hernia to form. This 
form of hernia contains small intestine and mesentery; 
however, they have been known to contain a small portion 
of the large intestine. These hernias consist of a mouth, an 
outer sack which is made up of skin and an inner sack which 
is made up of peritoneum. The hernial mouth is usually 
made up of the umbilicus which has not properly healed. 
This form of hernia comes on very early in life, while the 
new formed connective tissue in the umbilical region is very 
soft and breaks easily. 

Symptoms — The symptoms of this condition consist in a 
round or oval, circumscribed, soft, painless swelling in the 
umbilical region, which is easily reduceable by pressure. In 
the horse this condition may vary in size from a bantam egg 
to a man's head in severe cases. In dogs it is usually the 
size of a hazel nut. As a rule the general condition of the 
animal is not affected and it very rarely happens that an 
umbilical hernia Avill become encarcerated. 



The Practice of Veterinary Surgery 141 

Prognosis — This condition is not looked upon as a serious 
disease, but more as a blemish or malformation, which under 
ordinary conditions is easily removable. 

Treatment — In very young animals the treatment is 
mainly expectative. In a great many cases this condition will 
disappear without any treatment as the animal grows older. 
The palliative treatment consists of irritations and bandages 
with plenty of massage. If the hernia is small it may be 
painted with nitric acid, or it may be blistered with the 
ordinary blistering agents. These agents have a tendency to 
cause swelling, which presses the bowel back into the 
abdominal cavity and by irritation causes the hernial ring to 
heal over. Another common method of treatment is to tie 
off the hernia or inject normal salt solution in the region of 
the hernia. Of the last mentioned methods a ligature is 
probably the most convenient. For this a long needle with 
a stout double thread is used. With the animal on its back, 
and the contents of the hernial sack in the abdominal cavity, 
proceed as follows : Draw up the hernial sack as tig'htly as 
possible and pass the needle in the center of the sack as close 
to the body as possible, then tie each way, taking care to 
draw the thread very tight. This will set up a great deal of 
irritation and cause the sack to slough, leaving a smooth 
cicatrix behind. The objection to using clamps is the fact 
that they may fall oflf or be accidentally removed before 
healing takes place ; this will allow prolapse of the viscera 
and death following. 

The radical treatment for this condition is operative. 
The most successful operation is performed as follows : Make 
an incision through the skin down to the peritoneum, push 
the peritoneum back into the abdominal cavity, expose the 
hernial ring about one inch back from the edges, scarify the 
edges and suture with a double row of sutures, drawing the 
free end of the hernial ring together. Then suture the skin 



142 The Practice of Veterinary Surgery 

and if necessary remove a portion of the skin so that the 
edges may be brought in close opposition. If the hernia is 
quite large this operation should be followed by a stout 
bandage applied around the body to remove the weight while 
healing. Complete healing usually takes place in about two 
weeks. 

Inguinal and Scrotal Hernia. 

Inguinal hernia is the result of bowel or mesentery 
passing through the internal inguinal ring into the inguinal 
canal. A scrotal hernia is about the same condition, except 
that the mesentery or bowel pass down through the canal 
into the scrotum. A scrotal hernia is the most common 
condition seen in ordinary practice. This condition usually 
occurs in young stallions, bulls and dogs. 

An inguinal hernia is often seen in geldings of any age. 

Cause — The cause is either a congenital malformation of 
the internal ring, causing it to be quite large, or an acquired 
enlargement of the internal ring due to hard pulling, straining 
While at work, or if in a case of colic the animal becomes 
tympanitic the ring will become enlarged. This condition has 
been known to follow galloping, running, backing the animal 
with a heavy load, etc. As a general rule acquired hernias 
are inguinal, while congenital hernia is usually scrotal. 

Symptoms — A scrotal hernia usually contains both bowel 
and omentum and usually occurs unilateral, but may be 
bilateral. The hernia itself is recognized by a soft, painless 
enlargement of the scrotum. This swelling is hot and dis- 
appears on a little pressure. By carefull}^ palpating this 
region an enlarged inguinal canal and internal ring may be 
felt. By rectal exploration this fact is quite readily proven. 
Ordinarily this swelling is the size of a man's fist, but it may 
become very large. This form of hernia is the most common 



The Practice of Veterinary Surgery 143 

in dogs and swine and may become exceedingly large. There 
are no general disturbances in scrotal hernia, as they very 
rarely become incarcerated. An analogous hernia is seen in 
bitches just posterior to the udder. 

A true inguinal hernia is usually unilateral and most 
commonly seen on the left side. The contents are usually 
small intestine. These hernias in horses are usually the size 
of a hen egg and in dogs about the size of a pigeon egg. 
This form of hernia is usually easy to replace by palpation 
and rectal exploration, except when it becomes incarcerated. 
So long as this hernia does not become incarcerated there 
are no general disturbances and the animal does not seem 
to be affected. There may be a slight straddling gait, but 
this is not common. Inguinal hernias have a tendency to 
become incarcerated and then they give rise to very grave 
symptoms, which frequently lead to death. Usually an 
incarcerated hernia does not give rise to any symptoms until 
it has run a course of from twelve to fifteen hours. 

Symptoms — The symptoms are those of colic ; if the loop 
of bowel becomes necrotic the pain is constant, pulse thread- 
like and temperature subnormal. Along with this there will 
be seen some symptoms of peritonitis. The local symptoms 
are a swelling which is very painful. This swelling frequently 
becomes very large. On motion the animal either straddles 
or is quite lame. On rectal exploration a loop of bowel is 
found to enter the internal ring. This method should always 
be used to prove the diagnosis. 

Treatment — The treatment of scrotal hernia in foals is 
often useless, as this condition readily rights itself as the 
animal grows older. In case it does not, it may be treated 
in the same manner as scrotal hernia in adults. 

The treatment for scrotal hernia in adults depends upon 
the following point : Is the animal too valuable to be 



144 The Practice of Veterinary Surgery 

castrated? If he is a valuable animal he may be made into 
an artificial ridgling or if unilateral may be castrated. 

The most suitable method of operating for animals that 
may be castrated is the so-called covered operation. This is 
performed as follows : Make an incision through the skin 
onto the tunica vaginalis. Strip the skin from the tunica 
vaginalis as far as possible, then cut through the tunica 
vaginalis, remove testicle, and tie oflf the tunica as far up as 
possible. This is done most easily with a curved needle and 
a double thread. Pass the thread through the center and tie 
both ways as tightly as possible. Then cut the tunica 
vaginalis about one-half inch from where it is tied off. After 
thoroughly cleansing the wound pack with cotton and suture 
the skin wound. In case this method is not readily carried 
out, the animal may be castrated and the canal well packed 
with cotton dipped in a one per cent solution of creolin or 
permanganate of potash. In doing this care must be taken 
so that the entire canal is well filled up to the internal ring. 
This will usually set up enough inflammation to cause the 
canal to be obliterated. A horse that is too valuable to be 
castrated may be treated in the same way, except that the 
testicle should be pushed into the abdominal cavity instead 
of being removed, then pack the canal. 

The treatment of either scrotal or inguinal incarcerated 
hernia consists in giving some hypodermic cathartic, which 
will cause peristalsis, then manipulate the scrotum and 
inguinal region with one hand and by means of the other 
hand in the rectum use taxis on the incarcerated loop of bowel. 
In this way it usually can be relieved. It is a great deal 
more convenient to cast the horse for this operation and in 
some cases it becomes necessary. If the condition cannot be 
relieved in this manner an operation may be resorted to, 
which is performed as follows : Incise the skin and sub- 
cutaneous tissue and then carefully open the tunica vaginalis, 



The Practice of Veterinary Surgery 145 

and by manipulation return the loop of bowel. If the 
incarcerated portion has swollen it is necessary to slit the 
internal ring with a probe pointed bistuory to return the loop 
of bowel. This incision will usually cause enough swelling 
to cause the internal ring to be obliterated and prevent the 
formation of another hernia; then return the tunica vaginalis 
and the skin. Sometimes it becomes necessary to perform 
the covered operation with castration (the same as scrotal 
hernia). 

Hernia Ventralis. 

This condition is seen mostly in dogs, cattle and horses 
in the above order. The most common cause seems to be 
lacerating wounds, contusions with a tearing or rupturing of 
the subcutaneous musculature. This condition is very rarely 
seen as the result of excessive contraction of the abdominal 
muscles, but has been known to occur in pregnant animals 
as the result of spontaneous muscle rupture. The hernial 
sack of these hernias is usually not very well developed and 
consists mainly of skin. The contents are usually large or 
small intestine, uterus, liver, and in some cases mesentery or 
bladder. In cases where this condition becomes chronic, the 
contents of the hernial sack usually become attached to its 
walls. 

Symptoms — The symptoms of ventral hernia in the acute 
stages consist in a painful, hot tumefaction, associated with 
more or less oedema. The oedema surrounds this tumefac- 
tion, and therefore it is almost impossible to palpate the 
mouth of the hernia and make a positive diagnosis. After 
the disappearance of the acute symptoms and the oedema, 
the characteristic symptoms of the hernia appear. On palpa- 
tion the mouth of the hernia may be felt, and the contents 
can be pushed back into the abdominal cavity. These hernias 
do not have a tendency to incarcerate and practically never 
lead to any serious symptoms unless they become very large. 



146 The Practice of Veterinary Surgery 

A hernia of the uterus is usually very large and in some 
cases the tumefaction may reach nearly to the ground. 

Treatment — The treatment of acute ventral hernia is 
palliative. A great many cases return and heal without any 
treatment. In acute cases cold applications and astringents 
should be given a good, fair trial before an operation is 
resorted to. Great care should be exercised in diagnosing this 
condition. It is frequently taken for an abscess or hematoma, 
and an incision is made. Cases of long standing in which 
there is a large opening are practically incurable. Bandages 
and massage give some relief. If a proper diagnosis has 
been made an operation may be resorted to, by cutting 
through the skin onto the peritoneum, separate the peritoneum 
from the musculature, suture the musculature as tightly as 
possible with heavy cat-gut, cover with iodoform ether and 
suture the skin. 

Diseases of the Rectum. 

Meclianical irritations to the rectum in horses is a very 
common condition. They are the result of irrigation, injec- 
tion, infusion, as well as the entrance of foreign bodies, 
and prolapsus recti. Such internal cases as foreign bodies, a 
partial rupture during parturition or spontaneous rupture due 
to excessive muscular contraction are of importance. 

Superficial irritations or lacerations to the mucous mem- 
brane give rise to bleeding. The blood may be seen on the 
feces or passed as such, or may be seen on the hand after rectal 
exploration. Later on there are symptoms of proctitis. Con- 
tusions of the periproctal connective tissue give rise to 
phlegmon, abscess and fistula formation with a septic infiltra- 
tion in the region of the rectum from below, that is through 
the vagina, usually leads to the formation of a fistula, uniting 
the rectum and vagina. Injuries to the forepart of the rectum 



The Practice of Veterinary Surgery 147 

lead to septic peritonitis and if perforated rapidly lead to 
death. 

Treatment — The treatment for perforations of the rectum 
is useless, as these conditions are incurable. Superficial con- 
tusions are treated with warm antiseptic infusions into the 
rectum. Periproctal abscesses should be opened as early as 
possible. 

Proctitis. 

This is an inflammation of the rectum and is usually 
brought on by some mechanical irritation as foreign bodies, 
or rectal injections of irritating substances as chloral, hot 
water or cantharides. It may also be due to prolapsus recti, 
fracture of the pelvis, following specific infectious diseases as 
influenza, anthrax, dysentery, distemper in dogs or metastatic 
periproctal abscesses. 

Symptoms — According to the cause there may be the 
following forms : Catarrhal, diphtheritic, suppurative, paren- 
chymatous, phlegmonous and hemorrhagic. The main symp- 
toms are straining, painful defecation, impaction, a croupous, 
diphtheritic hemorrhagic or suppurative coating on the feces. 
By examining the rectum manually the proctal mucous mem- 
brane is found to be swollen, hot and reddened. In cases of 
phlegmonous proctitis there are large phlegmonous swellings. 

As a result of the excessive straining in this disease there 
may be a prolapse of the rectum with necrosis of the mucous 
membrane, peritonitis or fistula formation. 

Treatment — The treatment consists in manual removal 
of the irritating substances, followed by antiseptic astringent 
clysters. These clysters should contain some mucilagenous 
or oily material. Periproctal abscesses should be incised as 
early as possible. 



148 The Practice of Veterinary Surgery 

Prolapsus Recti. 

In diagnosing this condition, care must be taken to differ- 
entiate between prolapsus and prolapsus recti. In prolapsus 
recti there is the prolapse of all or a part of the rectum 
through the anus. It may occur that along with this there 
is an invagination of the abdominal portion of the rectum 
with the pelvic portion, with a prolapse of the invagination. 
If this invaginated portion contains a loop of small intestine 
it is known as hernia recti. 

Cause — The causes of this condition are usually predis- 
posing, and it is seen mainly in young dogs and swine as well 
as horses. There seems to be congenital weakness of the 
sphincter and the periproctal connective tissue. This, along 
with diarrhea or constipation, causes a prolapse. Gastric 
catarrh, difficult parturition, excessive straining in defecation 
and colic may be followed by this condition. 

Symptoms — The symptoms are those of a various shaped 
tumefaction passing through the anus. On the end and 
usually through the center of this tumefaction an opening 
can be found which exposes a canal. If the tumefaction con- 
tains small intestine it has a tendency to point upward, other- 
wise it points downward. In acute cases there is no change 
in the condition of the mucous membrane, but in cases of long 
standing there is stasis of the venous circulation, oedema and 
gangrene of the mucous membrane. Very chronic cases may 
contain excoriations, ulcers, hemorrhagic areas and necrosis, 
which gives rise to a general septic infection and peritonitis. 

Treatment — The treatment of this disease is usually very 
effective, if the general condition of the animal is not affected. 
It consists in dissecting the necrotic mucous membrane from 
the muscular coat. This is best done with the forefinger and 
thumb. After this has been removed the parts should be 
thoroughly cleansed, lubricated and returned. Give the animal 



The Practice of Veterinary Surgery 149 

laxative diet and keep quiet for several days. In some cases 
it becomes necessary to amputate the prolapsed parts, it is best 
to pull out the prolapse as far as it is affected. Then with a 
needle and thread pass through the center from side to side 
and from top to bottom. Remove the prolapsed portion with 
a pair of scissors and there will be eight sutures to tie. Tie 
these and if necessary add a few more. If this method is not 
found convenient, a piece of tubing can be taken the exact size 
of the rectum. After being well cleansed and lubricated, it 
may be passed into the rectum until its center is up to the 
anus. Now a stout thread may be passed around the invagina- 
tion portion to the tubing. The prolapse may be removed 
with a pair of scissors and healing usually takes place in three 
to four days. The tubing must be held in position until heal- 
ing takes place, and the animal must be kept on a laxative diet 
and the wounds treated with antiseptic astringent washes and 
dusting powders. Various astringent ointments will be found 
very serviceable, especially those containing opium or some 
other agent that will act as a local anodyne. 

Fistula of the Rectum. 

A fistula of the rectum is not common in the domesticated 
animals, but may result from a periproctal abscess or pene- 
trating wounds from the outside. There are two forms of this, 
these are complete and incomplete. In the complete form 
there are two openings, one in the rectum and one in the skin. 
In the incomplete form there is but one opening, and that is 
in the skin. This form of fistula is very nearly incurable, and 
should be treated with escharotics, iodoform ether, astringents, 
bacterial vaccines and antistreptococcic serum. 

Stenosis of the Rectum. 

A stenosis of the rectum may occur as a result of an 
injury causing a stricture, or as a result of a cicatrix, or it may 



150 The Practice of Veterinary Surgery 

be caused by various new formations as sarcoma, carcinoma, 
hematoma, abscess, tumefaction of the prostate, concrements, 
or in some cases there has been found a congenital stenosis. 

Symptoms — A stenosis may give rise to impaction, colicky 
symptoms, excessive straining followed by rupture of the 
rectum, and eventually peritonitis. 

Prognosis — If this condition is due to stricture from 
cicatricial contracture it is incurable ; if it is due to some other 
cause, the cause may be removed and the rectum treated ac- 
cordingly. 

Treatment— There is no specific treatment for this ail- 
ment. 

Paralysis of the Rectum. 

Paralysis of the rectum is seen mostly in dogs, less often 
in horses and is usually due to some lesion in the spinal cord. 
It may follow an infectious or contagious disease. This condi- 
tion is usually accompanied by a paralysis of the bladder and 
tail as well. 

Symptoms — The symptoms consists in difficult defecation, 
the feces being passed only in small quantities, and later on 
in the course no feces are passed at all. As a result of this 
there is impaction and colic. 

Prognosis — I'he prognosis should be guarded. 

Treatment — The treatment consists in areolin, strychnin, 
manual removal of feces and plent)^ of liquid food. 

Calculi in the Bladder and Urethra. 

The calculi which are found in the urinary tract of do- 
mestic animals usually occur in the bladder, while in geldings 



The Practice of Veterinary Surgery 151 

they may be seen in the urethra at a point where it passes 
over the pelvic arch. 

Causes — The causes of these formations are usually such 
diseases as pyelitis, pyelonephritis, cystitis, an excessive 
amount of various salts in the urine, or bacteria in the bladder, 
which cause a decomposition of the urine with a precipitation 
of its salts. 

Symptoms — The symptoms of this condition are not 
noticed unless the calculus becomes very large. Then they give 
rise to- dysuria, hemorrhagic, catarrhal, suppurative, or diph- 
theritic cystitis. These calculi can be palpated through the 
rectum. If they become lodged in the urethra they cause a 
stoppage in the passage of urine, and give rise to straining 
with the passage of small quantities of urine and blood. As a 
rule the calculus can be felt and easily removed. A damming" 
up of the urine may lead to serious symptoms with rupture of 
the bladder and peritonitis. 

Prognosis — The prognosis is usually favorable. 

Treatment — The treatment consists in performing lith- 
otomy through the urethra (in geldings) with removal of the 
calculus. If the calculus is in the bladder, in a gelding pass 
a catheter, and at the pubic arch cut through the urethra, and 
by means of forceps pass into the bladder and remove the 
calculus. In a mare incise the meatus urinarius and pass 
forceps into the bladder. It may be that the calculus must be 
crushed before it can be removed. After operating suture the 
urethra to the skin, and after three days remove the sutures 
allowing the wound to heal by second intention. 

Cryptorchidy. 

The term cryptorchid signifies a retained or hidden testicle. 
Technically we understand by this term a condition whereby 



152 The Practice of Veterinary Surgery 

the testicle remains in the abdominal cavity and does not 
make its descent into the scrotum. When the testicle is 
retained in the inguinal canal, it is known as an inguinal 
cryptorchid (flanker). As a rule this condition is congenital 
and only one testicle is retained. This is known as monorchid 
and generally appears on the left side. This condition appears 
mostly in coarse bred horses and swine. 

Cause — The cause of this condition has never been defi- 
nitely demonstrated. The supposition is that the develop- 
ment of the organ is very slow, the cord is short, the canal is 
narrow, and as a result tlie testicle remains free in the abdom- 
inal cavity. 

In a case of an abdominal cryptorchid, the testicle is 
always found free in the abdominal cavity and as a rule in 
the region of the internal inguinal ring. On the aiTected side 
there is no appearance of a scrotum. 

In a case of an inguinal cryptorchid the testicle is found 
in the inguinal canal, and the coverings of the testicle are 
present. It may occur that the testicle is in the abdominal 
cavity, but the epididymus will be in the inguinal canal and 
covered over with coverings of the testicle. 

The retained testicle is usually smaller and softer than 
the normal testicle. It is usuall}^ flat or fig shaped. The fact 
that the testicle may be covered over with small filaments and 
attach itself to the wall of the abdomen has been known to 
occur. It may happen that occasionally the testicle is exceed- 
ingly large, this being due to cyst formation or some new for- 
mation within its substance. A condition in which there is 
but one testicle present may exist ; this is known as aplasia. 
The spermatozoa which are secreted by a cryptorchid testicle 
are usually very small and rarely fertile. 

Symptoms — The symptoms of this condition is the failure 
of one or both testicles to appear in the scrotum. In this con- 
dition there is usually great sexual excitement and a viscious 



The Practice of Veterinary Surgery 153 

disposition and temperament, which is manifested by kicking, 
striking and biting. These animals also show less develop- 
ment of the croup and buttocks than normal animals. 

Diagnosis — The diagnosis of cryptorchid is made by pal- 
pation externally and by rectal exploration. Usually a com- 
bination of the two is sutificient. In flankers, if the animal is 
cast and the hand passed as far up the canal as possible, the 
testicle can usually be detected as a smooth round body. This 
condition is ver}^ hard to diagnose in rough built yearlings, as 
they have the power of drawing the testicle far up in the 
inguinal canal. To make a positive diagnosis rectal explora- 
tion must be resorted to. The testicle can be felt in the region 
of the internal ring. It is smooth, firm, movable, well defined, 
and feels somewhat like a sack containing mercury. If fol- 
lowed out to the cord the pulsation of the artery may be felt. 
Usually there will be a castration cicatrix on one side of the 
scrotum. This is not a positive factor, however, and can only 
be as a means of diagnosing, and not as a positive proof. Then 
these animals usually show great sexual excitement. If the 
animal be allowed sexual intercourse an ejaculation will be 
positive proof. If it contains spermatozoa this proves beyond 
a doubt that there is a testicle present. 

Operation for Cryptorchidy. 

This consists in casting the animal in the dorsal recum- 
bent position and securing the hind legs. An ordinary side 
line will not suffice for this operation. After the hind legs are 
well flexed and drawn outward, proceed to thoroughly cleanse 
everything. Next make an incision in the usual place as for 
an ordinary castration. This incision should be made quite 
large and only through the skin. Then with the hands tear 
the connective tissue and expose the external ring and the 
inguinal canal. Pass the hand down the canal to the internal 

II 



154 '^^^ Practice of Veterinary Surgery 

ring. This is covered with peritoneum, break through the 
peritoneum and the testicle will usually push through. If the 
testicle does not push through, pass the hand into the abdom- 
inal cavity. After the hand is in the abdominal cavity, pass 
the forefinger in a semicircle trying to catch the cord. This 
will usually locate the cord when the testicle can be drawn 
out. Remove the testicle with an emasculator in the ordinary 
way. In a great many cases it is not necessary to pack the 
wound, but it is good practice to pack the wounds for twenty- 
four hours. At the end of this time there is no more danger of 
prolapse of the viscera as the parts will be swollen and prevent 
this. 

Some authorities state that this operation may be per- 
formed as follows : Make an incision over the external region 
in the crus. Then with the hands tear the connective tissue 
and expose the external ring. Pass the cone shaped hand in 
front of the inguinal canal, and rupture through in front of 
the internal ring. The objection to this procedure consists 
mainly in that it does not provide proper drainage and unduly 
injures the tissues by avoiding the inguinal canal. In the 
majority of cases the first method of procedure will be found 
most satisfactory. 

Orchitis. 

Orchitis is due to traumatisms and external injuries, or 
by metastasis following or occuring during the course of some 
infectious and contagious disease, as glanders, tuberculosis, 
pyemia and parasites. It may be that this inflammation is a 
periorchitis and not a true orchitis, for which it may be mis- 
taken. 

Symptoms — The symptoms of acute orchitis are a firm 
painful swelling of the testicles, and in some cases this also 
involves the epididymus. Then there may appear stiffness, 
lameness, colicky symptoms, and some general symptoms as 



The Practice of Veterinary Surgery 155 

fever. It very rarely happens that there is abscess formation 
or necrotic processes present in the testicl-es. Chronic orchitis 
is made manifest by a firm, painless swelling of the testicles. 
As a rule, it is due to inters'titial orchitis follow^ing tuberculosis 
or glanders w^ith caseation or calcification w^ithin the testicle 
itS'elf or the testicle may contain an atheromatous cyst. 

A periorchitis involves the serous coverings of the testicle 
and may be serous (hydrocele) or adhesive. 

Treatment — The treatment of orchitis consists in remov- 
ing the v^^eight, by having the animal w^ear a suspensory. Then 
apply moist heat in the form of warm water, antiphlogistics 
followed by liniments and ointments. Internally, in the acute 
cases, aconite and phytolacca should be given. 

There may be such new formations in the testicles as 
sarcoma, sarcocele, fibrocarcoma, carcinoma, dermoid cysts, 
tubercular lesions and glanders lesions. These are made 
manifest by hard, painless swellings of the inguinal lymph 
glands. The treatment of this condition consists in castrating. 



DISEASES OF THE SPERMATIC CORD. 

Fistula of the Spermatic Cord or Schirrus Cord. 

Fistula of the spermatic cord is generally the result of 
infection following castration. In a great many cases the 
ends of the cord are left so long that they hang in the wound 
and become infected. This condition involves not only the 
free ends of the cord, but the neighboring serous membranes 
and in some cases the scrotum. The most common infections 
causing" this condition are botryomycosis, actinomycosis and 
ordinary pus cocci. An infection of botryomycotic origin is 
very common in horses and results from infected straw and 
bedding. After gaining entrance in the wound this infection 



156 The Practice of Veterinary Surgery 

sets up a specific tumefaction, which is in part suppurative and 
in part an induration of the free end of the cord. 

An infection of actinomycotic origin is very common in 
the ox, less common in the horse. The infection is carried by 
infected straw and bedding. An infection of staphylococci can 
also produce a chronic suppurative induration of the spermatic 
cord. There are certain predisposing conditions whereby this 
infection may gain entrance and find the proper media to 
grow. A very small castration wound seems to favor this, 
clamping instead of using an emasculator, and improper anti- 
septic precautions before and after the operation. Then the 
skin wound may heal too rapidly and enclose a sack of pus. 
This would lead to abscess formation with a resulting cham- 
pignon. 

Symptoms — The symptoms of this condition are noticed 
by the fact that the castration wound does not heal and dis- 
charges pus from a very small, round opening. This may be 
accompanied by a phlegmonous swelling which will appar- 
ently heal. By careful examination there is found a small, 
constricted, fistulous canal. It may happen that there is more 
than one fistulous opening. By palpation the cord is found 
indurated and the surrounding tissue swollen. The rapidity 
with which they develop varies greatly. Some only reach the 
size of a goose egg after a year of growth, while others attain 
the size of a man's head in two or three weeks growth. On 
the cut surface this tumefaction is grey in color and fibrinous. 
It also shows fistulous canals, which discharge a yellowish 
pus. Microscopically botryomycosis appears as greyish 
nodules somewhat like sand. If the case is of long standing 
there will be numerous large veins on the periphery as large 
as a man's finger, while the center veins are a great deal 
smaller. 

Prognosis — The prognosis is generally favorable. 



The Practice of Veterinary Surgery 157 

Treatment — The treatment of this condition consists in 
extirpation of the tumefaction. This is done by making an 
incision through the skin, then, with the hands, separate the 
tumor from the surrounding tissue, when the normal cord is 
exposed remove the entire mass with an ecraseur. It is best 
to treat the wound as an open wound in the ordinary manner. 

Hydrocele. 

This is a serious inflammation of the coverings of the 
testicle and cord. It is properly known as periorchitis serosa. 

In diagnosing a case of this kind four forms are to be 
considered, acute, chronic, diffuse and circumscribed, and 
these must be distinguished from each other. This serous 
fluid is either free and as such, or there may be small pockets 
formed which resemble cysts, which contain the serous fluid. 

Cause — The causes of this condition are not accurately 
known. Some authors seem to think that it may be con- 
genital, others think it follows castration in which the incision 
was very small and healing took place too early. It may 
follow a traumatic infection of the tunica propria. Various 
parasites may gain entrance to the tunica propria and give 
rise to a chronic serous inflammation. In very rare cases a 
hydrops of the tunica propria is seen in ascites. Sometimes 
castrating with clamps will lead to the formation of vaginal 
cysts. 

Symptoms — The symptoms of chronic hydrocele consist 
in a soft elastic, painless swelling around the testicle and cord. 
In acute cases this may be painful and hot. This greatly 
resembles hernia, in acute cases, and great care must be taken 
in making a diagnosis. Vaginal cysts as the result of castra- 
tion i-esemble a testicle and are soft and painless. A proper 
diagnosis can only be made with a trocar. 

Prognosis — The prognosis is favorable. 



158 The Practice of Veterinary Surgery 

Treatment- — The treatment of hydrocele consists in cas- 
trating and making long free incisions at the point of castra- 
tion. In case it is a vaginal cyst a complete extirpation of 
the cysts is necessar}^ This may be followed by painting 
with iodiine or Lugol's solution. If the patient is a valuable 
stallion and castration is not advisable, puncture with a trocar 
and draw off as much fluid as possible. Then inject some 
Lugol's solution through the trocar. This should be followed 
by massage and astringent lotions applied externally. 

Hematocele is a collection of blood within the tunica 
vaginalis and is usually due to traumatisms and may result 
in hydrocele. Varicocele is a dilatation of the veins of the 
spermatic cord forming a soft elastic tumor. This condition 
is frequently seen in cryptorchids and old stallions. 

Diseases of the Scrotum and Sheath. 

Wounding of the scrotum and sheath is very rare with 
the exception of castration woundfe. Superficial wounds in 
this region heal very rapidly. Perforating wounds with infec- 
tion in this region are usually quite serious as they lead to 
septic vaginitis and periorchitis. Perforations in this region 
which have become infected, should be opened with free in- 
cisions and well drained. 

In dogs there may be seen an eczematous or suppurative 
inflammation of the skin of the scrotum as a result of traumat- 
isms or some irritating application. This may lead to a cir- 
cumscribed necrosis but is ver}' rare. This condition is very 
seldom seen in other animals. 

Treatment — The treatment consists in antiseptic oint- 
ments as boric acid, ariol paste, etc. 

A phlegmonous condition of the sheath may occur as the 
result of traumatisms, castrations, or during the course of 
fistula of the spermatic cord. It is characterized by a firm 



The Practice of Veterinary Surgery 159 

swelling, which is painful and warm, causing the animal to 

be stiff and lame. 

*■ 

Prognosis — As a rule the prognosis is good but may leave 

a thickening of the sheath. 

Treatment — The treatment consists in opening the castra- 
tions wound so that it cannot retain the wound secretions, 
and removing the fistula or disinfecting and draining the 
wound, which is a causative factor. 

Balanitis. 

In a great many geldings an inflammation of the inner 
surface of the prepuce is seen as a result of a collection of 
smegma. This is characterized by a smeary or crust like 
smegma on the inner surface of the prepuce which results in 
thickening, ulceration, sclerosis, and eventually stenosis of 
the prepuce. As a result of this condition there may be a 
blocking of the urethra causing dysuria, colic, cystitis, neph- 
ritis, or rupture of the bladder. If the condition causes a 
stenosis of the prepuce the urine passes from the urethra 
within the prepuce, and the penis cannot be protruded. This 
usually leads to an atrophy of the penis. An inflammation of 
the prepuce may result from petechial fever or some inter- 
ference with urination. 

Treatment — The treatment consists in carefully cleansing 
the prepuce and irrigating with creolin one per cent ; formalin 
one-half of one per cent, and the application of some astringent 
antiseptic ointment. Stenosis is treated by incising the pre- 
puce and extirpation of the cicatrix. Cases of atrophy of the 
penis are incurable. 

Preputial catarrh is often seen in the dog. It consists of 
a catarrhal inflammation of the mucous membrane as the result 
of urination. The treatment consists in irrigation with zinc 
sulphate, alum, tannin, and boric acid solutions. 



i6o The Practice of Veterinary Surgery 

Inflammation of the Prepuce in the Ox. 

This ?s usually due to faulty urination and leads to a 
chronic inflammation with thickening and swelling of the 
prepuce. This inflammatory process leads to a stenosis of 
the prepuce and disturbances in urination as straining, or the 
urine is constantly passed in drops, colic, dysuria and rupture 
of the bladder. In very severe cases this may lead to a septic 
or necrotic phlegmon with gangrene and necrosis of the penis, 
infiltration of the surrounding tissue with urine, and sep- 
ticaemia. 

Treatment — The treatment consists in incising the stenosis 
and irrigating the prepuce with antiseptic astringent washes. 

Phimosis and Paraphimosis. 

Phimosis is a condition in which there is a stenosis of 
the mouth of the prepuce which prevents protrusion of the 
penis and leads to disturbances as dysuria, and inflammation 
of the prepuce. As a rule this condition is acquired as a result 
of a cicatrix of some previous disease. It has been known to 
be congenital but this is very rare. This condition occurs 
most frequently in the ox, horse and dog. 

Treatment — The treatment consists in incising and re- 
moving the cicatrix or a portion of the prepuce. 

Paraphimosis is a condition in which the prepuce is so 
badly swollen that the penis is protruded and cannot be re- 
tracted. This condition is seen mostly in dogs and horses 
after castration when the swelling becomes very severe. It 
may also occur from contusions, wounds, tumefactions, etc. 

Treatment — The treatment consists in manual reposition 
of the penis and massage of the prepuce. If it becomes neces- 
sary the prepuce may be incised. This should be followed by 



The Practice of Veterinary Surgery i6i 

thoroughly massaging- and the application of astringent 
washes. 

DISEASES OF THE PENIS. 

Paralysis of the Penis. 

Cause — The exact causes of this condition are unknown. 
It very rarely appears primarily, but is nearly always secondary 
to some other disease as chest plague, diseases of the spinal 
cord, fracture of the vertebrae, azoturia, thrombo-embolic colic, 
petechial fever, traumatisms to the penis itself, injuries to the 
motor nerves in the penis, or following the castration of a 
cryptorchid. 

Symptoms — The main symptom of this condition is a 
prolapse of the penis in which it protrudes from the prepuce. 
As a result of this it becomes injured and covered with excoria- 
tions, suppurative inflammatory processes, chronic phlegmon 
and in some cases it even becomes gangrenous. There are 
two distinct portions to the prolapsed penis. First the lower 
portion involving only the glans penis is a firm tumefaction. 
Above this and separated by a distinct furrow is a second part. 
This second portion is a round swelling which is sclerotic and 
involves mainly the connective tissue. These swollen parts 
prevent the penis from being retracted and lead to a para- 
phimosis. Urination is not interfered with as a rule. It often 
happens that there is a paralysis of the tail and crus along 
with a paralysis of the penis. If the paraphimosis becomes 
severe there may be oedematous swellings of the hind leg. 

Treatment — The treatment of this condition is practically 
worthless, especially if severe and chronic. Such treatments 
as massage, electricity or injections of strychnine may be used, 
but the radical treatment consists in amputation. In amputa- 
ting great care must be exercised so that there will not be a 
stricture of the urethra left. A long free incision in the urethra 



1 62 The Practice of Veterinary Surgery 

with suturing the walls to the skin seems to be the most satis- 
factory. 

There may be such new formations on the penis as car- 
cinoma, sarcoma, endothelioma and angiosarcoma. These 
usually lead to an atrophy of the penis and necessitate its 
amputation. 

Diseases of the Female Genital Organs. 

Lacerations of the vulva are seen mostly after difficult 
parturition, as the result of rough handling, the rough use of 
instruments, large foetus or fractured bones of the foetus. 
These lacerations and bruises are usually in the form of 
excoriations or hematomas. There may be a laceration on 
the upper commissure, which may lead to the formation of a 
cloaca. Frequently these wounds lead to wound infectious 
diseases and puerpural infection. As the result of cicatricial 
formation there may be obliteration or stenosis. 

Treatment — The treatment of these wounds consists in a 
disinfection and if possible suturing. If it consists in a hema- 
toma this should be opened. If these wounds lead to puer- 
pural infection they should be cauterized. 

Injury to the vagina usually occurs as the result of diffi- 
cult parturition, prolapse of the vagina, copulation, fracture 
of the pelvis, or the entrance of foreign bodies into the vagina. 
These wounds are either superficial or penetrating. If the 
perforation is in the abdominal cavity there may be a pro- 
lapse of bladder, mesentery or bowel, followed by septic peri- 
tonitis. Perforations on the upper surface usually involve 
the rectum and lead to the formation of a cloaca and recto- 
vaginal fistula. These wounds may also be followed by 
wound infectious diseases as phlegmon of the periproctal 
connective tissue, necrosis, puerperal septicaemia, pyaemia 
and tetanus. These wounds may be accompanied by a dis- 
charge, which is foul smelling as well as straining. As a result 



The Practice of Veterinary Surgery 163 

of these wounds there may be cicatricial formation, leading 
to stenosis and in some cases obliteration with retention of 
pus and abscess formation beyond the obliteration. 

Treatment — The treatment consists in antiseptic irrigation 
and tampons. Perforating wounds that become infested are 
necessarily fatal and usually treatment is not indicated. If 
there is a prolapse of mesentery do not replace but thoroughly 
cleanse and remove. 

Vaginitis. 

This condition is seen most commonly in the cow, follow- 
ing difficult parturition and copulation. 

Cause — It is partly due to traumatisms and partly to in- 
fection. It very rarely happens that chemical and thermic 
irritations cause this disease. The infection comes from the 
hands, instruments or from the uterus. In rare cases it may 
be carried by metastasis. Specific forms of vaginitis are seen 
in glanders, tuberculosis, dourine, and vesicular exanthema. 
In some cases vaginitis is seen to accompany endometritis and 
contagious abortion. 

Diagnosis — In diagnosing a case of vaginitis the following 
forms are distinguishable : Simple, superficial, catarrhal, trau- 
m.atic, suppurative, necrotic, diphtheritic, submucus, phleg- 
monous, chronic, hyperplastic, follicular, granular and varicose. 

Symptoms — The symptoms of inflammation of the vagina 
are straining as if to micturate, discharging a slimy mass or 
in some cases this may be suppurative, necrotic, bloody or 
diphtheritic. The animal shows great pain when the parts 
are touched. When the animal strains, the back is arched and 
it shows pain. There is a reddening and swelling of the 
mucous membrane of the vagina. This may also be covered 
by blisters, vesicles, ulcers, or diphtheritic areas. In chronic 



164 The Practice of Veterinary Surgery 

cases there are cysts, polyps and tumefactions on the mucous 
membrane. This disease may lead to stenosis and obliteration 
with a pus sack behind the stenosis. If this condition is due to 
puerpural infection, there are general symptoms and symptoms 
of sepsis. 

Treatment — The treatment consists in astringent anti- 
septic washes and irrigation as creolin, lysol, alum, ichthyol, 
potassium permanganate, etc. 

Prolapse of the Vagina. 

This condition occurs mostly in the ox, dog and swine, 
less often in the horse. It is usually seen in old cows of a 
lymphatic disposition, and those that have given birth to a 
great number of calves. It is also seen in younger animals as 
the result of excessive straining from any cause. 

Cause — The causes are usually seen in the food and the 
stall. Stalls that are lower behind than before seem to pre- 
dispose to this condition. It also occurs as the result of some 
nervous disorder. It usually occurs within the last two months 
of pregnancy or immediately following parturition. It has 
been seen to occur in young heifers and non-pregnant cows. 
Animals that are poorly fed seem to be affected mostly. 

Symptoms — The symptoms of prolapse of the vagina are 
classified as partial and complete, acute, chronic, or habitual. 
An inversion of the vagina consists in the side walls and the 
upper portion of the vagina extending outward toward the lips 
of the vulva. 

An incomplete prolapse consists in a round, red, elastic 
tumefaction, between the lips of the vagina, which is easily 
pushed back and appears mainly when the animal is in- a lying 
posture. This condition often becomes habitual or chronic, 
which may even last years. A complete prolapsus of the 



The Practice of Veterinary Surgery 165 

vagina consists in a very large tumefaction between the lips 
of the vulva. In this condition the meatus urinarius and the 
OS uteri, are on the surface of the tumefaction. The visible 
mocous membrane is swollen, thickened, dark in color, covered 
with excoriations, mucous and in some cases a bloody exudate. 
Later on this may become gangrenous. There is continual 
straining as if to micturate. This condition nearly always 
renders the animal barren, and from a forensic standpoint 
may be looked upon as an unsoundness. 

Treatment — The treatment consists in carefully cleansing 
and replacing. After replacing, have the animal wear a truss. 
If this is impractical, a few stitches may be taken into the 
vulva and the animal given some antispasmodic internally. 
If the animal is in a lying posture, see that the hind parts are 
well elevated. 

New Formations in the Vagina. 

There may be such new formations as polyps, fibromas, 
fibrolipomas, a hyperplasia of the connective tissue and the 
mucous membrane. In cows there are sometimes seen cysts 
filled with a clear fluid resembling a vesicle, which fluctuates 
and is usually on the left wall. There may be formed blood 
cysts, which are usually encapsulated hematomas as the result 
of an injury. 

Hermaphrodism. 

Sometimes it will happen that mares will have a penis 
instead of a clitoris. This condition is known as pseudo her- 
maphrodism masculinus. This condition is usually relieved 
by removal of the penis. 

OCCLUSION OF THE VAGINA. 

Occlusion of the vagina, as the result of coition, is quite 
Gommon. During copulation wounds are produced, producing 



1 66 The Practice of Veterinary Surgery 

inflammaition with the vagina assuming a funnel shape. This 
leads to the retaining of fluids in the uterus with general symp- 
toms and enlargement of the uterus. 

Treatment — The treatment consists in opening the vagina 
and OS with the hand, followed by antiseptic irrigation. 

INJURIES TO THE UTERUS. 

Injuries to the uterus are usually received during par- 
turition by means of instruments, extremities of the foetus, 
etc., prolapse of the uterus, torsion or spontaneous rupture, 
and in rare cases octernal injuries. These wounds ma}^ affect 
the musculature, serous membrane or mucous membrane. 
These may be superficial or penetrating. A spontaneous rup- 
ture of the uterus and penetrating wounds are usually fatal. 
Superficial wounds are frequentl}' accompanied by severe 
hemorrhage. Wounding of the cervix very rarely leads to 
complications. The treatment of wounds of the uterus con- 
sists in antiseptic irrigation, astringents, packing the uterus 
with ice or giving hydrastis internally. 

Metritis. 

According to the cause, character and part affected 
metritis may be divided into the following forms : Septic, 
puerperal, traumatic, catarrhal, hemorrhagic, suppurative, 
croupous and phlegmonous. In regard to the cause it may be 
divided into acute and chronic. 

From a practical standpoint the part of the uterus affected 
is of the most importance. If the mucous membrane is affected 
it is known as endometritis; if the musculature is affected it 
is called metritis and if the peritoneum is affected it is known 
as perimetritis. If it is a phlegmonous inflammation of the 
parametrium it is known as parametritis. In puerperal sep- 
ticaemia and pyemia all of the uterus is affected. From a 



The Practice of Veterinary Surgery 167 

clinical standpoint there are the following forms : Endome- 
tritis, septic metritis and parametritis (phlegmon). 

Catarrhal Endo Metritis. 

This is a superficial catarrhal inflammation of the mucous 
membrane of the uterus. It appears in practice in two forms, 
acute and chronic. It consists in a hyperaemia and swelling 
of the mucous membrane with the secretion of a muco-puru- 
lent exudate. 

Cause — The most common causes of this disease are re- 
tention of the placenta and difficult parturition, with injury 
and infection. This disease usually appears within from four 
to six days after parturition, but may not put in appearance 
until a later date. In cows it is often caused by prolapse of 
the uterus, vesicular exanthema and by tubercular lesions. 

Symptoms — The symptoms of catarrhal endometritis con- 
sists in a greyish or yellowish foul smelling discharge from 
the vulva. This discharge may contain albumenous admix- 
tures and be of a muco-purulent nature. 

In severe cases there may be such general symptoms as a 
slight rise in temperature, anorexia, lessening of the milk 
secretions, straining as if to urinate and sometimes painful 
urination, straddling gait and stiffness. After a few days 
there may be swelling of the vulva and vagina. After the 
acute symptoms have lasted from two to three weeks it passes 
over into the chronic form (leucorrhea). In the chronic form 
there are no general symptoms. The most prominent symp- 
tom is a catarrhal vaginal discharge. This is muco-purulent 
in some cases. In case this exudate cannot be expelled from 
the uterus and a large quantity collects in the uterus it is 
known as hydrometa or pyometra. A simple chronic catarrhal 
endometritis very rarely gives rise to general symptoms but 
cases of hydrometra frequently lead to pyaemia. 



i68 The Practice of Veterinary Surgery 

Prognosis — The prognosis is favorable if treated properly. 

Treatment — The treatment of acute endometris consists 
in frequent irrigations of astringent antiseptics, as alum, tannin, 
boric acid, sodium bicarbonate, potassium permanganate, 
creolin, lysol, etc. In some cases it is necessary to give arti- 
ficial stimulation. Chronic catarrhal endometritis is almost 
incurable, but should also be treated with astringent antiseptic 
irrigations. Internally large quantities of arsenic and general 
tonics should be given. 

Septic Metritis. 

This condition is also known as puerperal fever, puerperal 
metritis, puerperal septicaemia. This condition is an inflam- 
mation of the mucous membrane and the musculature of the 
uterus, brought on by the entrance of the infection into the 
uterus, which may result in general pyaemia. The starting 
point of the disease is abrasion or laceration to the uterus 
during parturition. The infection is carried into the uterus by 
the hands and instruments or from a decomposing foetus or 
afterbirth. 

Symptoms — The symptoms of septic metritis usually come 
on in from three to five days after parturition. The first symp- 
toms are straining and uneasiness. The temperature is about 
104 degrees F. symptoms of laminitis, fetid chocolate colored 
discharge from the vulva, the pulse is rapid and weak and the 
animals seem to have pain and are very uneasy. There is 
continual straining as if to micturate and the afifected animals 
are very tender to the touch over the abdomen. 

Prognosis — The prognosis should be guarded. 

Treatment — The treatment consists in constant antiseptic 
irrigation of one per cent creolin, lysol, alum, tannin, potassium 
permanganate. Internally give artificial stimulation as alcohol, 



The Practice of Veterinary Surgery 169 

aromatic spirits of ammonia, tincture of camphor, ammonium 
carbonate, etc. ; also echinacea, potassium iodide or nuclein. 

Prolapsus Uteri. 

This condition occurs most frequently in cows after par- 
turition or as the result of a retained afterbirth. A prolapse 
of the uterus consists first in inversion followed by prolapsing 
through the vulva. 

Cause — The causes are usually continued following par- 
turition, pulling on the afterbirth and nervousness. Such con- 
ditions as phlegmatic temperament, partial paresis of the uterus 
and poor nutrition may be looked upon as predisposing causes. 

Symptoms — This condition is characterized by a large 
tumefaction passing out of the vulva. When the animal is in 
a standing position it may reach the hocks. This tumefaction 
is covered with small, roseate bodies (cotyledons). After the 
uterus has been prolapsed for several hours the mucous mem- 
brane becomes dark, swollen, friable, and in some cases gan- 
grenous. The entire tumefaction becomes very large and 
swollen ; if the animal is down, it may be torn and on its sur- 
face there may be decubital ulcers. If this condition is not 
properly treated it may lead to septicaemia or pyaemia. 

An inversion of the uterus without prolapse is very rarely 
seen. This is brought on by constant straining. On examin- 
ing the parts the body of the uterus will be found in the 
OS uteri in the form of a round tumefaction. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in carefully cleansing 
the prolapsed uterus with reposition. After reposition some 
measures must be resorted to to keep the uterus in position. 
This may be accomplished by allowing the animal to wear a 
truss, giving chloral or some hypnotic internally. Before 

12 



17© The Practice of Veterinary Surgery 

attempting a reposition, carefully cleanse the uterus with cold 
water containing alum or creolin. Cold water is indicated, 
for it causes contraction of the uterus and keeps the cow from 
straining. Warm water is contra indicated, as it causes the 
animal to strain and reposition is almost impossible. In re- 
placing the uterus it is most convenient to have the animal in 
a standing position. The uterus should be placed on a towel 
covered with powdered sugar and held by an attendant. Then 
an attempt should be made to pass the hand through the pro- 
lapsed uterus into the vagina. In this way it will usually be- 
come adherent to the arm, and as the arm is pushed forward 
the uterus will follow. After reposition is accomplished the 
uterus should be packed with ice or filled with very cold water. 
It may be necessary to apply a truss or take one or two stitches 
in the lips of the vulva. Some authorities state that tracheoto- 
my is of considerable service in these cases. 

In those cases where the prolapsed uterus cannot be re- 
placed, amputation may be resorted to. This is done as fol- 
lows : First ascertain that there are no intestines or mesentery 
in the prolapsed portion of the uterus. Thoroughly cleanse 
everything and apply an elastic ligature around the uterus as 
closely to the vulva as possible. Then with a knife remove 
the uterus within about one inch from the ligature. After 
removal push the stump back into the vagina and irrigate once 
daily with some astringent antiseptic. 

Torsio Uteri. 

This condition is seen most frequently in cows but may 
occur in mares and bitches. Torsio uteri consists of a twist- 
ing of the uterus on its long axis and comes on during preg- 
nancy just before parturition. 

Cause — The cause is supposed to be undue activity of the 
foetus, shipping, overloading of the digestive apparatus, run- 
ning, being cast in the stall or over-exertion of some kind. 



The Practice of Veterinary Surgery 171 

Symptoms — The symptoms of torsion or a twisting of the 
uterus are a turning on its long axis of one-quarter, one-half, 
three-quarters, one full turn or being turned twice. This 
twisting may be to the right or left. At the time of parturition 
there is a great straining and the appearance of the water sack. 
On rupturing this sack there is usually no water present. By 
manual exploration a twisting of the vagina with spiral folds 
in its side walls may be felt. The vagina is narrow and con- 
tracted. If there is complete torsion it is impossible to pass 
the hand into the uterus. The way in which the torsion turns 
may.be determined by the direction of the folds on the vagina. 
If this condition is not relieved the animal dies from septic 
metritis, internal hemorrhage or strangulation. It may be 
possible for an animal to live one or two weeks in this con- 
dition, but it is rarely the case. 

Prognosis — The prognosis is doubtful and should be 
guarded. 

Treatment — The treatment consists in casting the animal, 
pass the hand into the uterus and grasp the foetus. Hold the 
foetus and roll the animal until the uterus is in its normal 
position. 

Retention of the Placenta. 

Retention of the placenta is usually due to some faulty 
condition of the uterus. This is seen mostly in cows and mares. 

Cause — ^This is usually due to a pathalogical condition of 
the uterus itself or the animal may be poorly nourished or a 
lack of postpartum contractions. It may follow in cases of 
abortion, accidental and infectious endometritis, fatty infiltra- 
tion in very fat animals, or it has been known to follow where 
the animal gave birth to twins. The placenta may become 
adherent to the walls of the uterus as a result of placentitis. 
If the cervix closes too rapidly the placenta may be retained 



172 The Practice of Veterinary Surgery 

as the result of this. Normally the placenta is passed in a 
mare in about one-half hour after parturition, and in a cow 
from one to six hours. 

Symptoms — The symptoms of retained placenta are as 
follows : There is usually a small part hanging from the vulva. 
After three or five days decomposition sets in and there is a 
brownish, foul smelling discharge from the vulva with fre- 
quent straining. As a rule the general condition is not greatly 
affected as the result of this decomposition. In severe cases 
there may be slight general symptoms. This condition usually 
leads to catarrhal endometritis, with a stinking, discolored 
discharge, general emaciation, gastric disturbances and lessen- 
ing in the milk secretion. It may occur that this condition 
may lead to septic metritis, puerperal septicaemia or tetanus. 
In some cases the placenta is retained, decomposition does not 
set in and resorption occurs. This usually gives rise to gen- 
eral emaciation and slight gastric disturbances. 

Prognosis — The prognosis should be guarded especially 
if the placenta is decomposed. 

Treatment — The treatment of this condition consists in 
manual removal of the placenta. This must be performed most 
thoroughly and the placenta removed in toto. If there is a 
small piece remaining it may give rise to severe general symp- 
toms. After removing the placenta, the uterus should be irri- 
gated at least six times with one per cent solution of creolin 
or permanganate of potash. Such medicinal agents as 
hydrastis, ergot or eserine should be given to cause a contrac- 
tion of the uterus. 

Tuberculosis of the uterus often occurs in the form of 
metritis. The mucous membrane is covered with ulcerations, 
nodules, and abscesses form in the walls of the uterus. These 
give rise to a discharge. The mode of infection may be by 
means of coition. The only visible symptoms are those of a 



The Practice of Veterinary Surgery 173 

muco-purulent vulval discharge. It may give rise to abortion, 
sterility, nymphomania, dilitation of the cervix, chronic thick- 
ening of the walls of the uterus. 

DISEASES OF THE MAMMARY GLAND. 
Mastitis. 

The most common forms of mastitis are due to an infec- 
tion. The infection is transmitted through the teat canal, the 
lymph stream and the blood stream. A great many cases of 
mastitis are due to specific infections as tuberculosis, actinomy- 
cosis, and botryomycosis. The common bacteria causing mas- 
titis are streptococci, staphylococci and micrococci. The pre- 
disposing causes are traumatisms, so-called catching cold, 
oedema of the udder and improper milking. 

The ancients taught that mastitis was due to catching 
cold and rough handling of the udder or improper milking. 
Recently we have come to believe that it is due to an infection. 
The infection gains entrance through the teat canal, passes up 
the canal and from there infects the entire udder. This causes 
the decomposition of milk, this in turn irritates the mucous 
membrane and the epithelium. 

There are three ways in which mastitis may be spread. 
First by means of the teat and milk duct (galactogenous mas- 
titis), secondly by the lymph stream through lesions in the 
skin and subcutaneous tissue (lymphogenous mastitis), and 
thirdly by the blood stream (hemotogenous mastitis). 

Oedema and Phlegmon of the Udder. 

Toward the end of gestation there is a congestion of the 
udder and as a result a great quantity of serum is thrown out 
into the subcutis. After calving, the udder becomes very 
painful and swollen so that milking is almost impossible. The 



174 ^^^ Practice of Veterinary Surgery 

udder is very hot and the skin is reddened. A wound infection 
may cause the same condition. 

Prognosis — The prognosis is favorable in most cases. 

Treatment — Massage with frequent milking, bathe the 
udder once an hour with warm water, apply warm lard and 
turpentine with plenty of massage, or camphorated oil and 
plenty of massage, or belladonna ointment freely with mas- 
sage. Nux vomica and phytolacco should be given internally. 

Abscess of the Udder. 

This affects only one-quarter of the udder. A hind quarter 
is more frequently affected than a fore quarter. 

Cause — This condition is usuall}^ due to wounds with 
direct infection. 

Symptoms — The symptoms are fever and a severe phleg- 
mon with abscess formation, the abscess involves the paren- 
chymatous and subcutaneous connective tissue. These 
abscesses point very slowly. In rare cases the abscess will 
discharge into the teat canal. The discharge from the abscess 
is very thick and bloody. 

Prognosis — The prognosis is usually favorable. The 
course is about three to four weeks. 

Treatment — The treatment consists in trying to cause the 
abscess to point by using antiphlogistine, Priesnitz packs, 
moist heat, liniments, etc. Open abscess and evacuate its con- 
tents as early as possible. Treat symptoms as they arise. 

Catarrhal Mastitis. 

This consists of an inflammation of the mucous membrane 
of the sinuses and canal. This inflammation spreads to the 
epithelium, causing a change in the secretion. 



v 



The Practice of Veterinary Surgery 175 

Cause — The cause is bacteria gaining entrance into the 
canal. 

Symptoms — The udder feels hard and nodular. The 
swelling is low down and affects only one quarter or a half of 
the udder. The gland tissue is not affected in the beginning 
of the disease. The milk that is drawn off is watery, flocculent 
and in some cases cheesy. This disease usually leads to sten- 
osis or obliteration of the teat canal, causing the animal to lose 
that quarter. The disease may also lead to pseudo-hyper- 
trophy, causing" so-called fleshy quarter. 

Prognosis — Prognosis is unfavorable so far as the affected 
part of the udder in concerned. 

Treatment — The treatment consists in hot water and 
plenty of massage, camphorated oil with plenty of massage, 
liniments, Phytolacca and nox vomica internally. 

Parenchymatous Mastitis. 

This particular form of mastitis is the most common. 
This involves the mucous membrane of the teat cistern and 
the epithelium of the gland. This disease may affect the 
entire udder or only one quarter. As a general rule only one 
quarter is affected. Hind quarters become affected more often 
than fore quarters. 

Cause — The cause is wounding of the udder. It is seen 
secondarily to foot and mouth disease and infectious aptha. 

Symptoms — The symptoms appear after a period of incu- 
bation of from two to three days. The udder is hard and 
tense, the skin is swollen and reddened, the animal shows 
great pain on pressure, the milk is very cheesy in consistency. 
Almost complete anorexia. The temperature is elevated and 
the animal may have a chill. 



176 The Practice of Veterinary Surgery 

Course — The course is short. The portion of the udder 
affected usually becomes atrophic. 

Prognosis — The prognosis so far as life is concerned is 
favorable, but the function of that quarter is lost. 

Treatment — The treatment consists in frequent milking 
with massage, use teat tube, treat the same as above. Pre- 
ventive treatment consists in careful handling of the udder 
and proper milking. 

Septic Mastitis. 

Cause — The cause of this form of mastitis is supposed to 
be due to metastasis. That is the pus cocci are carried by the 
blood and then lodged in the udder. It usually follows septic 
metritis or septic gastro-enteritis. This disease is not very 
common but does occur occasionally. 

Symptoms — The symptoms are a high fever, 103 to 105 
degrees, the pulse is 90 to 100 per minute, the respirations are 
25 to 40 per minute, the udder is severely swollen, on milking 
there comes a dark, bloody, stinking discharge. In some cases 
almost pure pus comes out. 

Prognosis — After three or four days the animal usually 
becomes cyanotic, collapses and dies. 

Treatment — There is no good treatment for this disease. 
Gangrenous Dermatitis of the Udder. 

By means of wound infection the skin and entire udder 
may become gangrenous. 

Symptoms — One or two days after the infection the milk 
appears dark and bluish, affected portion of the udder swells 



The Practice of Veterinary Surgery 177 

and becomes reddened and generally only one quarter is 
affected. 

Course — The course is two to three days. 

Prognosis — The prognosis is favorable. 

Treatment — The treatment consists in antiseptic oint- 
ments. 

Infectious Gangrenous Mastitis. 

This disease is contagious and usually there is more than 
one animal affected. The disease appears sporadic and 
enzootic. 

Symptoms — One quarter of the udder becomes bluish in 
color and cold; from the teat there exudes a dark stinking fluid. 
No general symptoms appear except in the first stages of 
severe cases. Later on the affected quarters drop on. 

Treatment — The treatment consists in surgical removal 
of the parts affected. 

Stenosis and Obliteration of the Teat Canals. 

Stenosis and obliteration of the teat canals occur quite 
commonly among cows. It is usually due to some traumatism 
or inflammatory condition. This may be in the form of a 
new formation or it may be congenial. Those stenosis that 
occur as the result of traumatic or inflammatory causes are 
usually cicatrices which form strictures as the result of con- 
tracture. The teat may receive an injury from the outside 
which would tear the mucous membrane and give rise to a 
circumbscribed traumatic inflammation, with the subsequent 



178 The Practice of Veterinary Surgery 

formation or nodular or circular cicatrices which cause a nar- 
rowing of the canal. 

There are various new formations which are formed in 
the lumen, the most common being papillomas. These are 
usually upon the mucous membrane of the canal, but may form 
in the cisterns. It very rarely occurs that fibromas form in 
this region. 

There may be a congenital atresia in which there is no 
opening in the teat, no teat canal and in some cases no cistern. 

Symptoms — The symptoms of stenosis of the teat canal 
begin by hard milking. The milk is forced out in very thin 
streams and considerable force must be used. In rolling the 
teat between the fingers it is tense and thick. By passing a 
teat tube or probe the exact condition can easily be felt. In 
chronic cases there is no pain, but in acute cases there is more 
or less pain. 

Prognosis — The prognosis is usually unfavorable in high 
stenosis as the treatment of these usually results in mastitis, 
while in a cow stenosis the prognosis is favorable. 

Treatment — The treatment consists in widening or en- 
larging the canal with bougies and tubes, or with a specially 
constructed instrument known as the "teat slitter." 

Milk Fistula. 

By the term milk fistula is designated an abnormal skin 
opening which discharges milk in the region of the mammary 
gland. This may be along the side of the teat or milk cistern 
and in very rare cases these openings may open directly into 
the gland itself. A fistula is distinguished from a fresh wound 
by the fact that it is almost painless and only slightly swollen. 



The Practice of Veterinary Surgery 179 

Cause — The causes of milk fistula formation are traumat- 
isms, abscesses, furunculosis, and in rare cases it may be 
congenital. Acquired fistula are usually brought on during 
the period of lactation. These fistulae are usually the result 
of faulty cicatrization because during the process of cicatriza- 
tion milk continually flows through the wound and as a result 
a fistula is formed. 

Symptoms — A milk fistula may appear on any part of the 
teat or udder. It manifests itself by a small, smooth, round 
opening with very thick walls. From this opening milk flows 
either constantly or during the act of milking. There are no 
symptoms of inflammation, reddening, swelling or temperature 
present. 

Prognosis — A fistula of the gland is more easily treated 
than a fistula of the teats. These fistulse will heal spontane- 
ously during the dry period. 

Treatment — The treatment consists in caustics or the 
actual cautery. After cauterization the opening should be 
closed by stitching. The edges of the fistulous opening may 
be curretted and stitched, after A^hich it should be dressed 
with ariol paste. If the cow is valueless the teat may be ampu- 
tated above the fistula. 

New Formation in the Udder. 

New formations in the udder are seen most frequently in 
bitches. Adenomas, fibroadenomas and carcinomas are the 
most common ; chondromas and osteomas also appear quite 
commonly. Sarcomas and lipomas are seen very rarely. 

Treatment — The treatment of these consists in amputa- 
tion of the gland. 

There are specific new formations in the udder which are 
seen most commonly. These arc due to a specific infection 



i8o The Practice of Veterinary Surgery 

which gives rise to a chronic productive inflammation. These 
are botryomycosis, tuberculosis, and actinomycosis. These 
give rise to large painless swellings which have a tendency to 
break down and discharge. In tubercular lesions the supra- 
mammary lymph gland is always affected. The diagnosis of 
the exact nature of these swellings depends a great deal upon 
the discharge. Tubercular lesions do not have a tendency to 
discharge, while actinomycosis and botryomycosis do have a 
tendency to discharge. These lesions may lead to abscess 
formation with subsequent fistula formation. 



i 



CHAPTER V 

DISEASES OF THE VERTEBRA., TAIL 
AND PELVIS 

Crural Paralysis. 

BY the term crural paralysis is meant a peculiar unsteadi- 
ness and weakness of the hind parts, which may be a 
partial or a complete paralysis. It is also known as 
paresis, paralysis, paraplegia or palsy. This condition is seen 
frequently in the horse, the dog and the ox. The pathological 
lesion has its seat in the cord, peripheral nerves, bone (verte- 
brae, pelvis or sacrum), muscles of the croup or in the vessels. 
Diseases of the spinal cord which may give rise to crural 
paralysis are pachymeningitis, myelitis spiralis, new forma- 
tions, tumefactions, and parasites. 

Cause — The cause of these diseases is usually contusion, 
freezing, stroke of lightning, various traumatisms, spread of 
an inflammation from a neighboring part, following infectious 
and contagious diseases (glanders, dog distemper), and vari- 
ous poisonings as mercury, etc. Also severe hemorrhage and 
parasites. Diseases of the peripheral nerve endings that may 
give rise to this condition are polyneuritis, injuries and con- 
tusions. 

Diseases of the musculature giving rise to this condition 
are traumatic, rheumatic, toxic, or infectious myositis, acute 
and chronic inflammatory conditions in this region. Crural 
paralysis is seen following haemoglobinaemia, lumbago, 
parenchymatous myositis and acute degeneration of the 
muscles, rupture or injury to a given muscle. 



1 82 The Practice of Veterinary Surgery 

Disease of the bones and joints causing this condition are 
fissures and fractures of the vertebra and pelvis, tuberculosis 
lesions in the bones mentioned, distortion and luxation of the 
vertebrae. 

Diseases of the vessels giving rise to crural paralysis are 
phlebitis and thrombosis in the vessels of this region or the 
lodging of an embolus. 

Symptoms — The symptoms of complete crural paralysis 
are a complete loss of motion of the hind parts. This paralysis 
is of both the motor and sensory nerves, in which the senso- 
dium is in a normal condition. The animal seems to have free 
use of the fore parts and will sit up or drag the hind parts 
around. There is also an almost complete paralysis of the 
bladder, rectum, penis, and tail. The animal does not respond 
to a pin prick in complete paralysis. 

In incomplete or partial paralysis there is a straddling, 
weaving gait. In advancing the legs they are elevated very 
high and somewhat resemble stringhalt. The sensibility is 
lessened but not entirely absent. The paralysis of the bladder, 
rectum and tail is very mild. In some cases urine drops from 
the bladder continually. 

Prognosis — The prop;nosis of incomplete crural paralysis 
is usually favorable, most cases recovering in less than two 
weeks. The prognosis of complete paralysis is less favorable 
when bilateral and usually quite favorable when unilateral. 
Unilateral cases usually recover in a week or ten days, while 
bilateral cases recover in a month. A great many cases of 
bilateral crural paralysis are incurable leaving the animal in a 
worthless condition so that it must be destroyed. The prog- 
nosis should depend upon the cause. In cases of fracture of 
the vertebrae it is most unfavorable. 

Treatment — The treatment of crural paralysis consists in 
irritating applications externally as massage, blisters, elec- 



The Practice of Veterinary Surgery 183 

tricity. Internally strychnin, rhus toxicodendron, veratrin, 
arecolin, and pilocarpin can be given. In cases of fat and 
phlegmatic horses phlebotomy should be resorted to and great 
care should be exercised in the feeding. Feed very little food, 
and that should be of a soft laxative nature. 

Ante Partum Paresis. 

This disease is usually seen in cows and appears at or 
before the time of parturition. This disease usually appears 
about ten days before parturition. It is very similar to crural 
paralysis. 

Cause — At the present time the exact cause is unknown 
but is supposed to be due to nervous disease. This disease 
must not be confused with contusion, distortion, luxation and 
fracture. 

Symptoms — The symptoms consist in a paralysis which 
renders the animal unable to get up, otherwise everything 
seems to be normal, rumination and digestion are normal and 
the sensorium is clear. 

Prognosis — The prognosis of this is favorable as it usually 
disappears after parturition. 

Treatment — The treatment consists in removing the 
foetus as soon as possible. Internally give nux vomica, rhus tox 
or strychnin, and externally use irritating applications. 

Post Partum Paresis. 

This is practically the same condition as ante partum 
paresis. The causes are unknown and it always comes on 
immediately after parturition. 

Prognosis — The prognosis is generally favorable. 



184 The Practice of Veterinary Surgery 

Treatment — The treatment is the same as for ante partum 
paresis. 

Fracture of a Dorsal or Lumbar Vertebrae. 

This condition is of practical importance in practice. The 
causes are mainly external or spontaneous fractures. Trau- 
matisms and injuries are mainly inflicted in an accidental way 
and are various. The spontaneous fractures are due to exces- 
sive muscular contraction with bowing and arching of the 
back. The vertebrae in the region of the attachment of the 
diaphragm seem to be fractured most commonly. The reason 
of this is that it is nearest the center of the arch and is the 
weakest point. Some diseases predispose to idiopathic frac- 
ture as rachitis, osteomalacia, atrophy of the bones, osteo- 
porosis, tuberculosis, ankylosis of the vertebrae. The frac- 
tures are usually communicated and crushed involving the 
body of the bone as well as the transverse process. These 
fractures are very rarely fissured. 

Symptoms — The symptoms of a fracture of a vertebrae 
depend upon the amount of fracture. A complete fracture is 
characterized by a suddenly appearing paralysis of the hind 
parts. This paralysis is of both the motor and sensory nerves. 
The motor paralysis is made apparent by the fact that the 
animal weaves and falls helpless to the ground. At the same 
time the bladder, tail and rectum become paralyzed. The skin 
does not react to a pin prick behind the fracture. The animal 
may show cold sweat in the region behind the fracture. Ab- 
normal niovem.ent and crepitation are absent in the horse but 
may be noticed in the smaller animals. Fissures are very 
hard to recognize and diagnose. The animals are uncertain 
in gait and show more or less weaving of the hind parts. In 
most cases the animals are worked regularly and in shorter or 
longer period of time the fissure becomes a fracture. A frac- 



The Practice of Veterinary Surgery 185 

ture of one of the processes is manifested by local symptoms, 
as swelling', heat, pain and crepitation. 

Prognosis — The prognosis of fractured vertebrae is always 
unfavorable and the animal should be destroyed at once. If 
the animals are not destroyed they will die from septicaemia 



and decubital gangrene. 



Fracture of the Pelvis. 

About thirty per cent of all fractures horses receive are 
fractures of the pelvis. 

Cause — The causes are usually falling, accidental injuries 
of various kinds, contusions, difficult parturition. Fractures 
due to muscular contraction are very rare and usually occur as 
the result of some diseased condition of the bone as osteoma- 
lacia and osteomyelitis. The most common fractures are frac- 
tures of the external angle of the ilium, tuber ischia, pubic 
symphysis, acetabulum, and occasionally the internal angle of 
the ilium. As a general rule there is more than one fracture 
present. These fractures may be compound involving the skin 
and peritoneum. Fissures of the pelvis may also appear but 
are very hard to diagnose. 

Symptoms — The first noticeable symptom is a suddenly 
appearing lameness. This lameness is both supporting and 
swinging leg lameness. There is also uncertainty in the gait, 
weaving, abnormal movement, and peculiar abducting and 
adducting movements. The visible deformity of the pelvis is 
also a very valuable diagnostic symptom. There is usually a 
sinking in of one-half of the pelvis, or the whole pelvis is 
changed in position, or one of the angles may be dropped. 
There may be a very severe swelling in the region of the 
rectum, or in the portion affected. In some cases there may be 
no apparent external symptoms. 

13 



1 86 The Practice of Veterinary Surgery 

Crepitation may be felt by moving the pelvis back and 
forth. Also this may be heard by placing the ear over the 
part and then moving the pelvis. Abnormal movement of the 
pelvis usually occurs when there is a fracture of one of the 
angles, causing the pelvis to drop and allow abnormal move- 
ment. Rectal examination in pelvis fractures is most important 
in cases of fracture of the pubis, ischium and acetabulum. By 
rectal examination the fracture may be located ; there will be a 
swelling, hemorrhage, abnormal movement and crepitation. 
Vaginal examination reveals the same thing. 

An animal suffering from pelvic fracture will show great 
pain, uneasiness and general symptoms, as fever, and anaemia 
of the visible mucous membranes, if an artery is involved. 
Symptoms of fractures of the individual bones of the pelvis 
may be diagnosed only by close inspection and examination. 

Prognosis — The prognosis of most pelvic fractures is 
favorable. A callus may form, which would render the animal 
useless for breeding purposes after difficult parturition. Frac- 
tures of the angles of the pelvis usually heal in from one month 
to six weeks. Compound fractures of the pelvis are usually 
considered incurable and the animal should be destroyed 
promptly. 

Treatment — The treatment consists in sling, rest, good 
feeding, and hygienic surroundings. The animal should be 
given syrup of lime, or phosphate of lime on the feed. 

Fracture of the Sacrum. 

The cause of fracture of the sacrum appears mostly in 
small animals and in large animals as the result of difficult 
parturition. It may also appear in young heifers as the result 
of accidental injuries, 



The Practice of Veterinary Surgery 187 

Symptoms — The symptoms usually result in a paraplegia 
the same as in fracture of the vertebrae. The main symptoms 
are a paralysis of the tail, rectum, penis, and bladder. 

Treatment — The treatment consists in symptomatic treat- 
ment. Unless the fracture is only partial, then recover}^ may 
take place by treatment with stimulants. A complete fracture 
is incurable and the animal should be promptly destroyed. 

Luxation of the Sacrum. 

This condition is seen mostly in cows and occurs as the 
result of difificult parturition. It may also appear in the mare 
but is v€ry rare, or in animals that are very far advanced in 
pregnancy and suffer from some accidental injury causing this 
condition. 

Symptoms — The symptoms of this condition are divided 
into partial and complete. A complete luxation of the sacrum 
gives rise to symptoms of paraplegia, the sacrum is sunken 
and there is crepitation and grating over the part afifected, the 
internal angle of the ilium appears to be raised. By rectal 
examination the sacrum is sunken into the pelvis, and the 
cavity appears to be very much smaller as the result of this. 

In partial luxation, which is by far the most common, 
there is an unsteady and weaving gait, stiffness, grating and 
crepitation at every step, and severe pain and crepitation on 
palpation over the affected part. 

Prognosis — The prognosis of a partial luxation is favor- 
able, recovery taking place in from three to four weeks. In 
complete luxation the prognosis is less favorable and in some 
cases bad. These animals suffer from decubital gangrene and 
die from sepsis. 

Treatment — The treatment consists in rest, irritating appli- 
cations over this region of the body and stimulation internally. 



i88 The Practice of Veterinary Surgery 

LUMBAGO. 

Myositis of the Croup-Muscles. 

In horses and dogs myositis does not appear as a rare 
disease. This disease usually runs under the picture of crural 
paralysis. 

Cause — The cause of this condition may be rheumatic 
hemoglobinaemia as a result of so-called catching cold, rheu- 
matic myositis. Also brought on by the so-called catching 
cold, as the result of casting, especially in phlegmatic horses, 
and a traumatic myositis which is brought on by injuries, as 
contusions, bruises, falling on the street, etc. 

Symptoms — The symptoms of hemoglobinaemia usually 
appear after a severe chilling shortly after leaving the stable. 
The animals will appear lame and stifif behind, they may weave 
and are very sluggish. They will not move until forced to, 
the croup muscles are stiff and hard, the urine is usually dark 
in color. As a rule in this disease one side of the croup is 
affected more than the other. 

Prognosis — This disease end's very rapidly in death or 
recovery, two d'ays being the longest time consumed in either 
case. A chronic myositis may be left over as the result of this 
condition, or a chronic crural paralysis with a partial paralysis 
of the penis. 

Symptoms — The symptoms of rheumatic lumbago are 
stiffness of the croup, arching the back, great pain when the 
animal moves or gets up. On manipulating this part of the 
body the animal shows great pain. This condition appears 
very commonly as the result of over-exertion and severe labor 
along with taking cold. 

The symptoms of lumbago which arise as the result of the 
animal being cast, are a painful swelling of the muscles, which 



The Practice of Veterinary Surgery 189 

causes the muscles to be stiff and the entire body to be carried 
stiffly. In three or four days there appears a degenerative 
atrophy of the involved muscles resulting in a severe atrophy, 
which takes the animal months to recover from. A very severe 
case of this kind closely resembles azoturia and may be fatal. 

Treatment — The treatment consists in slinging the animal, 
rest, massaging the affected parts, blistering the affected parts 
or some irritating application. Hypodermically eserine, areco- 
line, pilocarpine or caft"ein should be given. If the animal is 
fat and phlegmatic, phlebotomy should be resorted to. In- 
ternally salicylic acid, salicylate of soda or antifebrin should 
be given as anti-rheumatic agents. In case the animal becomes 
very restless some narcotic may be given. 

Thrombosis of the Iliac and Femoral Arteries. 

Cause — The causes of thrombosis are the lodging of an 
embolus in the bifurcation. These emboli come from the heart 
or the posterior oarta, as the result of chronic deforming en- 
darteritis or endocarditis necrosa. This form of thrombus is 
the form that causes the so-called intermittant lameness in 
horses. 

The pathological condition of this disease is as follows : 
At the point of division of the posterior oarta and the branches, 
there is a thickening and hardening of the walls of the vessels 
and the formation of an organized thick thrombus. The lumen 
of the vessels is narrowed and as a result of this the-remainder 
of the vessels undergo a compensatory hypertrophy. 

Symptoms — The symptoms of this disease appear only 
after a period of exercise. During a period of rest no symptoms 
of this disease are shown. During a period of exercise there is 
a characteristic lameness of the hind parts, which at first is 
very slight, but later on becomes very severe and renders the 
animal useless. After a short period of rest these symptoms 



I go The Practice of Veterinary Surgery 

entirely disappear. These symptoms may appear in one or 
both legs. This lameness is a mixed lameness and is peculiar 
to this disease. The symptoms usually start with weaving 
and apparent weakness of these parts. The feet are dragged 
and it seems impossible to move the legs forward. These 
animals nearly always go down, along with this lameness, there 
are general symptoms of distress, dyspnoea is noticed, the 
pulse runs high, the heart beat may be heard several feet away 
from the body, the animal shakes and trembles and the body 
is covered with sweat. No pulsation can be felt on the affected 
side or sides. B}^ rectal palpation the thickening may be felt 
and there is no pulsation in the affected artery. Usually a 
period of fifteen to twenty minutes is necessary for all of these 
symptoms to abate. 



CHAPTER VI 

DISEASES OF THE HIP 

The So-called Hip Lameness. 

THIS lameness is very characteristic and similar to shoul- 
der lameness. It is a typical swinging leg lameness and 
is brought on by a very great variety of diseased condi- 
tions in this part of the horse. In some cases this lameness 
may be mixed and appear in a great many forms. Swinging 
leg lameness is noticed particularly when the animal extends 
and flexes the leg or in raising or lowering the foot. In very 
severe lameness of the hip the animals do not bear any weight 
on the foot. 

Cause — The causes of this condition may be located in 
the musculature, bursse, nerves, vessels and joints. Diseases 
of this joint consist in distortion, luxation or coxitis. Diseases 
of the bone causing this condition are fracture, periostitis, and 
osteomyelitis. Diseases of the muscalature causing this con- 
dition may be contusion, laceration, rupture, myositis, and 
partial paralysis. 

Diseases of the bursa are mainly inflammation in the form 
of bursitis, and the diseases of the nerves are mainly paralysis. 

Coxitis. 

This is an inflammation of the coxo-femoral articulation. 

Cause — The cause of coxitis in animals is usually an 
acute subluxation of the hip joint with a resulting inflamma- 
tion. It is usually due to traumatisms of an external and acci- 
dental nature, missteps, jumping and running, or there may be 



192 The Practice of Veterinary Surgery 

the spread of an inflammation from a neighboring tissue. 
Pyaemia is a very important cause of coxitis in foals. 

Symptoms — The symptoms of coxitis, especially distor- 
tion and acute coxitis, consist in suddenly appearing lameness, 
which makes itself manifest by movement. By manipulating 
the leg great pain will be shown. In the region of the 
coxo-femoral articulation there may l^e swelling, heat, or pain, 
or these symptoms may be negative. 

Chronic deforming coxitis is accompanied by severe muscle 
atrophy, and the formation of an exostosis in the region of the 
joint. 

Prognosis — The prognosis of acute coxitis is favorable, 
while that of chronic coxitis is unfavorable. Chronic coxitis 
usually manifests itself in the form of a chronic incurable 
lameness. An acute lameness may also terminate unfavorably 
by rupture of the capsule or capsular ligament, or an injury to 
the joint surface. 

Treatment — The treatment consists in rest, moist heat, 
blistering agents and eventually cautery. 

Luxation of the Femur. 

Luxation of the head of the femur very rarely occurs in 
the horse, but is seen most commonly in the dog or ox. As a 
rule it is of traumatic origin and due to over-exertion, casting, 
faulty stepping, etc. It may also be due to various pathological 
conditions, as an animal sufifering from a deforming coxitis is 
predisposed to luxation of the femur. 

Symptoms — The symptoms of luxation of the femur 
usually consist in a luxation toward the upper and outer part 
of the fossa. The characteristic symptom is a shortening of 
the affected leg, severe lameness, there is no free movement 
of the leg as that is hindered by this condition, the hip has a 



The Practice of Veterinary Surgery 193 

peculiar aspect and the general condition and position are 
changed. 

Prognosis — The prognosis of this condition is usually- 
unfavorable for the capsule is torn, and there is a severe 
hemorrhage into and around the joint. The prognosis is also 
rendered unfavorable by the fact that the leg cannot be 
bandaged, and the result is the formation of a false joint 
(nearthrosis). This false joint eventually becomes serviceable 
and after a long period of rest the animal may again be 
serviceable. However, there is always a slight chronic lame- 
ness left behind. 

Fracture of the Femur, 

The causes of fracture of the femur are mainly mechanical 
injuries. This condition is seen most commonly in dogs and 
less frequently in horses. When this condition does occur in 
the horse it is usually due to casting, or spontaneous fracture 
due to some pathological condition of the femur, with an 
excessive muscular contraction. 

Symptoms — The symptoms consist in an immediate high 
grade lameness, abnormal movements in the affected leg, pain, 
swelling, and crepitation in the region of the fracture and in a 
great many cases shortening of the leg itself. 

Prognosis — The prognosis depends upon the part fractured 
and the extent of the fracture. If it is a fracture of the body 
the prognosis is unfavorable, if the fracture involves one of the 
trochanters, the prognosis is most favorable. 

Treatment — The treatment consists in rest, sling and 
casting in dogs, if possible. 

Myositis of the Femoral Muscle. 

The causes of this condition are contusions, bruises, tear- 
ing or rupturing of the femoral muscle. These muscles are 
very apt to become affected. 



194 '^^^ Practice of Veterinary Surgery 

Symptoms — The symptoms consist in unilateral lameness, 
which is as a general rule swinging leg lameness. This lame- 
ness may become so severe that a fracture of the pelvis is 
susceptible. Locally there is pain, swelling, heat, and in some 
cases the formation of a hematoma. If the muscle is ruptured, 
there will be typical symptoms of a depression and the ends of 
the muscle may be plainly felt. If this condition is of long 
standing, there is a severe atrophic condition of the muscles. 

The course of this disease is usually acute, as it follows 
accidents from street cars, falling, being run into, etc. 

Prognosis — The prognosis of this condition is favoraljle. 

Treatment — The treatment consists in moist heat, mas- 
sage, liniments, and blistering agents. Subcutaneous injections 
of strychnin and veratrin are also very serviceable. Hematomas 
should be opened and drained. 

Paralysis of the Quadriceps Femoris. 

This condition is commonly called crural paralysis, but is 
a misnomer. Formerly the cause of this condition was thought 
to be a nervous disease, but recently we have come to know 
that only a few cases of this condition are neurogenous, by far 
the most of the cases are myogenous. 

Cause — A myogenous quadriceps paralysis is due to a 
parenchymatous myositis, which is usually the result of azo- 
turia. On section the affected muscle is found degenerated 
and it has undergone an inflammatory process. It is greyish in 
color and in most cases has undergone fatty degeneration. 
These same symptoms may also occur as the result of severe 
over-exertion of the muscle. However, the majority of these 
cases have their origin in azoturia. 

A neurogenous quadriceps paralysis is usually due to 
tearing, rupturing, or contusions of the nerve trunk itself. This 
of course is not very common. 



The Practice of Veterinary Surgery 195 

Symptoms — ^The symptoms of quadriceps paralysis con- 
sists in a breaking- down of the entire leg during motion, that is, 
it is unable to bear the strain that is thrown on it as the result 
of motion. This collapse seems to be most marked in the 
region of the stifle. After this condition has been present for 
a short time a severe degenerative atrophy takes place, making 
the condition all the more grave. Eventually the quadriceps 
entirely atrophies and appears just like a thin aponeurosis. 
All other symptoms are negative. 

Course — The course of this condition is usually chronic, 
lasting for months. In a great many cases it is necessary to 
destroy the animal on account of this condition being incurable. 
Healing of this condition is very slow, taking several months. 
Healing in a short time is relatively uncommon. 

Prognosis — The prognosis of this condition is as a whole 
unfavorable, as about seventy per cent of all cases are rendered 
worthless. The prognosis is more unfavorable in bilateral 
cases. 

Treatment — The treatment consists in rest, massage, elec- 
tricity, blistering agents, firing and subcutaneous injections of 
strychnin. The most essential thing is gentle exercise given 
regularly. In order that this may be done it is best to turn 
the animal out to pasture or it should be given great freedom. 

Bursitis Trochanterica. 

This condition occurs quite commonly among horses and 
consists in an inflammatory condition of the tendon and bursa 
of the gluteus medius. 

Cause — It is usually the result of contusions as falling, 
being struck, and in some cases over-exertion may cause it. 

Symptoms — The main symptoms consist in a painful in- 
flammatory swelling in the region of the trochanter. In case 



196 The Practice of Veterinary Surgery 

it is fibrinous bursitis there may be crepitation. The animal 
shows swinging" leg lameness when the leg is rotated toward 
the inside. 

Course — The course is usually acute, but may become 
chronic as a result of exostosis formation in this neiglibor- 
hood. This results in a chronic lameness with muscle atrophy. 

Treatment — The treatment consists in rest, massage, moist 
heat, liniments and eventually blistering and firing. 

DISEASES OF THE STIFLE. 
Acute Gonitis. 

Acute gonitis is an acute inflammation of the stifle joint. 

Cause — In animals it is usually the result of traumatic 
injuries, contusions, distortions and all manner of wounds. It 
may also occur as the spread of an inflammatory process, 
especially suppurative phlegmon, suppurative tendo-vaginitis 
and also as the result of pyaemia. 

According to the cause and anatomical character of the 
lesion there are two forms, acute serous aseptic and infectious 
suppurative or gangrenous. 

The acute serous gonitis, also known as acute hydrops, 
usually results from traumatic injuries to the joint capsule. 

Symptoms — The symptoms are a rapid swelling, which is 
hot, painful, soft and fluctuating. There is very severe lame- 
ness on motion and there are no general symptoms. 

The acute suppurative gonitis is characterized by a very 
severe swelling, which is dififuse, very painful and hot, high 
grade lameness and general symptoms of septicaemia and 
pyaemia. 

Prognosis — The prognosis of suppurative gonitis is un- 
favorable usually resulting in death. The prognosis of the 



The Practice of Veterinary Surgery 197 

acute serous is usually favorable but should be made with care 
as there is apt to be a chronic lameness left over in the form of 
a chronic deforming gonitis. Acute serous gonitis may also 
develop chronic hydrops of the joint. 

Treatment — The treatment consists in moist heat, mas- 
sage, blistering and rest in case of acute serous arthritis. 
Septic arthritis usually runs a very severe acute course and 
should be opened and treated accordingly. 

Chronic Deforming Gonitis. 

Cause — The causes of chronic deforming gonitis are over- 
exertion, hard and severe w^ork, distortions and contusions. It 
usually results from an acute form. Predisposing causes of 
this condition are faulty position of the hind leg, weak con- 
stitution and extreme youth when put to work. 

Symptoms — The symptoms of chronic deforming gonitis 
consist mainly in chronic lameness, which is not noticeable 
after a long period of rest. If the animal is put to very hard 
work the lameness becomes more severe. The lameness con- 
sists in a tripping or hopping gait. The affected limb is held 
in a flexed position when the animal is at rest. The lameness 
becomes more severe if the joint is severely flexed for a few 
minutes, then the animal moved off. After the disease has 
been in existence for several months, there is a noticeable 
swelling in the region of the joint, which is permanent. The 
entire joint is thickened. On the inside of the joint, well down, 
there is a swelling which is cold, painless, circumscribed and 
semi-solid. After this disease has been present for some time, 
there appears a severe muscular atrophy of the entire hip 
musculature, especially the quadriceps femoris. There is great 
pain shown on passive movement of the joint. By laying the 
hand over the joint during passive movements crepitation can 



198 The Practice of Veterinary Surgery 

be readily felt. Animals suffering from this condition very 
rarely lie down as it is very painful. 

Chronic deforming gonitis is a typical inflammatory and 
degenerative process of the bone, cartilage and joint capsule. 
In the bone there is a subchondral rarefying ostitis, with later 
a condensing ostitis. Secondarily the cartilage becomes aflfected 
beginning on the edge and working to the center. The carti- 
lage becomes bluish red in color and is covered with erosions. 

The capsule of the joint has undergone a marked thicken- 
ing, causing the joint to appear twice the normal size. The 
synovial membrane is very red and vascular, the surface is 
rough and covered with erosions. These erosions sometimes 
appear like polypi. In the joint itself there are floating par- 
ticles, which appear to be fibrinous or cartilaginous in origin. 
The synovia is dark brown in color, fibrinous, and thicker in 
consistency than normal. 

The edges of the joint are covered with exostosis of various 
sizes. These are usually the consistency of cartilage. 

Prognosis — The prognosis of this condition is not favor- 
able. Unilateral gonitis is more favorable than bilateral gonitis. 
Bilateral chronic gonitis is usually considered an incurable 
condition. 

Treatment — The treatment consists in rest, massage, blis- 
tering and firing. 

Luxation of the Patella. 

Luxation of the patella occurs in all animals. It appears 
in the form of traumatic luxation or an abnormal contracture 
of the quadriceps. Spontaneous luxation of the patella is seen 
in young emaciated animals and in young animals in which 
the cartilage of the femur is too flat. This condition is con- 
genital in some animals. 



The Practice of Veterinary Surgery 199 

There are various forms and grades of luxation of tlie 
patella. There is momentary luxation, habitual luxation, 
stationary luxation, complete and incomplete luxation. From 
a practical standpoint there are two very common forms, which 
are important. These are luxation of the patella upward and 
luxation of the patella outward. 

Luxation of the Patella Upward. 

This form is most common in young animals and may be 
stationary, momentary or habitual. 

Cause — Stationary luxation of the patella upward is 
usually the result of a traumatism or over-exertion. The patella 
glides past the condyle and remains, causing a peculiar stiff- 
ness of the entire leg. The leg may be in a flexed or extended 
position. 

Symptoms — If the animal tries to go forward the leg is 
usually dragged. By palpating the leg the patella can be 
easily located and the patellar ligaments will be found to be 
very stifif and contracted. By carefully manipulating the leg 
the patella will be heard to slip back into place. 

After this all symptoms abate and the animal walks in the 
normal manner. As the result of this displacement there is an 
acute inflammatory swelling of the joint. A momentary sta- 
tionary subluxation does not necessarily injure the animal 
permanently and nia}^ never occur again. 

A habitual luxation occurs without any apparent cause. 

Symptoms — It is noticed in walking and turning around. 
Suddenly the animal cannot walk, is stiff and the affected leg 
is immovable, or it may appear constantly and at every step 
there is heard that peculiar snapping sound, which is produced 
by the slipping of the patella over the condyle. In other 
cases the animal may assume a gait which is very similar to 
stringhalt. 



200 The Practice of Veterinary Surgery 

Prognosis — The prognosis of stationary luxation is favor- 
able, especially in older animals. It may or may not appear 
again. The prognosis of habitual luxation is less favorable 
and usually proves to be chronic. 

Treatment — The treatment of stationary luxation consists 
in reposition of the patella. This is done by manipulating the 
patella with the hand, allowing the assistant to flex the leg. 
After the patella is replaced the animal should have a long 
period of rest. Over the joint there should be applied a severe 
blistering agent. 

The treatment of habitual luxation consists in a long 
period of rest, the application of blistering agents over the 
entire joint or the application of cautery. The animal should 
be put in slings after the application of the actual cautery. If 
this is not feasible an operation consisting of severing the 
middle straight ligament of the patella should be performed. 

Luxation of the patella outward is a very rare disease and 
does not occur commonly. This may be a complete or incom- 
plete luxation also. The symptoms consist in lameness and a 
short jerky stride in incomplete luxation. However, complete 
luxation consists in a complete lameness and a complete break- 
ing down at every step. By local palpation the patella can be 
plainly felt out of place. 

The prognosis of this is unfavorable and the treatment is 
the same as above. 

Bursitis Subpatellaris, 

The causes of bursitis subpatellaris are usually of trau- 
matic origin with the resulting formation of a tumor like mass 
which resembles a shoeboil in form. 

Symptoms — The symptoms consist in a circumscribed 
tumefaction under the skin and above the tibia. This tumefac- 
tion is about four inches below the joint. In very acute cases 



The Practice of Veterinary Surgery 201 

this is hot, painful, and often times fluctuating. If the skin is 
broken in the accident, there usually results a phlegmon or 
suppurative bursitis. Older cases usually present a hygroma 
formation or a fibrous tumor. The acute stages of this disease 
usually give rise to symptoms of lameness. 

Treatment — In mild cases the treatment consists in paint- 
ing with tincture of iodine or camphor with puncture. Sup- 
purative bursitis should be opened freely, drained and irrigated 
antiseptically. A hygroma should be extirpated. 

DISEASES OF THE LOWER PORTION OF 
THE HIND LEG. 

Wounds and Phlegmon. 

The lower portion of the hind limb seems to be predis- 
posed to traumatic injuries and punctured wounds. As the 
result of wounds in this region, there is danger of wound infec- 
tious diseases. The most common of these is subfascial 
phlegmon or subcutaneous phlegmon ; the next common is 
suppurative tendo-vaginitis and the least common periostitis. 

Subfascial Phlegmon. 

This consists in a ditTuse, painful, hot, firm swelling in 
the region of the wound. This gives rise to lameness, general 
sepsis and necrosis of the surrounding tissue. This condition 
may result in tendon rupture, fistula formation or excessive 
granulation. Very se\'ere cases de\elop into septic phlegmon 
which results in septicaemia. 

Treatment — The treatment consists in free incisions with 
antiseptic irrigation. Spirits of camphor and tincture of iodine 
are very valuable in this condition. 



202 The Practice of Veterinary Surgery 

Contusions of the Tibia. 

Contusions to the inner surface may involve the skin sub- 
cutaneous periostium or bone. If these wounds become in- 
fected they may result in suppurative periostitis or ostitis, 
ossifying periostitis, necrosis or bone as well as fistula forma- 
tion. 

Prognosis — The prognosis in these cases should be made 
with great care, for there may be a fissure present, which 
would eventually form a complete fracture. 

Treatment — The treatment consists in tying the animal 
so that it cannot lie down, disinfecting the wound and giving 
it good drainage. In some cases it is necessary to curette the 
wound thoroughly. 

Fracture of the Tibia. 

The causes of fracture of the tibia are mainly of mechan- 
ical origin. However, there are some general diseases that 
may predispose to fracture of the tibia. 

Fractures of the tibia may be classified as complete and 
incomplete. Complete fractures of the tibia are mainly com- 
pound and green stick fracture. 

Symptoms — The symptoms of complete fracture of the 
tibia are a very suddenly appearing lameness following an 
accident. This lameness is high grade supporting leg lame- 
ness, causing the animal to hop on three legs. There is 
abnormal movement in the portion of the leg below the frac- 
ture, crepitation and a painful swelling at the point of frac- 
ture. 

Fissures are not so easily diagnosible. Fissures are sus- 
pected rather than diagnosed properly. There is local swelling 
and pain and in a great many cases a distinct pain line. 

Prognosis — The prognosis of complete and compound 
fracture of the tibia is unfavorable in grown horses. The bone 



The Practice of Veterinary Surgery 203 

will heal but there will be a chronic incurable lameness re- 
maining. The prognosis of fissures is more favorable, and will 
heal if a complete fracture does not develop as a result of it. 
A complete healing usually takes place after several months. 

Treatment — The treatment should be slings, plaster casts, 
rest and tying the animal so that it cannot move in any direc- 
tion. 

Rupture of the Tendon of Achilles. 

Rupture of the tendon of Achilles or tearing loose from 
its origin or insection occurs in animals quite frequently. It 
may appear as a result of an abnormal contraction of the 
gastrocnemius, over-exertion of A-arious kinds, jumping and 
running. 

Symptoms — The symptoms consist in a peculiar flexed 
position of the hock while walking and in the standing position. 
While walking there is a peculiar unsteadiness and jerking of 
the joint. The entire leg breaks over at the joint at every step. 
Locally the rupture may be felt. If it is detached from the 
OS calcis, a piece of the bone may be broken off with it. 

Prognosis — The prognosis is usually unfavorable as it is 
almost incurable. If it should heal there is apt to be a chronic 
lameness left over. 

Treatment — The treatment should consist in rest and a 
cast. 

DISEASES OF THE HOCK JOINT. 

Spavin. 

By the term spavin is designated a chronic inflammation 
of the joint, which is most effective on the lower, inner part of 
the joint. Primarily a spavin is an ostitis of the lower row 
of tarsal bones; secondarily this results in a chronic deforming 
arthritis and peri arthritis with exostosis formation. This 



2Q4 The Practice of Veterinary Surgery 

exostosis may appear any place on the external surface of the 
joint. The causes of spavin may be classed as external and 
predisposing. 

Cause — The external or direct causes are mainly mechan- 
ical contusions, over-exertions, as straining, sticking fast in 
the mud and early usage. 

The supposition is that more uneven pressure is brought 
on the inner surface of the joint with the result that this por- 
tion is mainly afifected. 

The predisposing, indirect or inner causes are mainly age 
and disposition, a poor conformation of the joint (the joint is 
tied so to speak), faulty position, small weak bones in the 
joint and faulty shoeing. 

Symptoms — Spavin lameness appears quite suddenly. It 
is most severe when the animal is taken from the barn and on 
exercise. The spavin test causes a very severe spavin lame- 
ness which is quite characteristic. In the stall moving toward 
the well side causes more or less pain. The lameness has a 
peculiar jerking gait, somewhat similar to stringhalt. The 
step is short and rapid in which the toe drags on the ground, 
causing the toe of the shoe to be worn off. In breaking over 
the animal seems to show the most pain. As a result of this, 
the hip muscles are not properly used and undergo atrophy. 
Later on the entire leg becomes atrophic. This atrophic con- 
dition is very characteristic of spa^'in lameness. The hoof 
becomes short and stumpy in accordance with the gait. 

The exostosis is not present in all cases. It has a char- 
acteristic position, but is not always present at that point. It 
may occur at any point over the surface of the joint. The 
exostosis is about the consistency of cartilage at hrst, later on 
it becomes about as hard as bone, painless, flat and circum- 
scribed in form. It is immovable and the skin is movable 
over it. Other symptoms are negative. 



The Practice of Veterinary Surgery 205 

Diagnosis — To make a positive diagnosis of spavin, cer- 
tain factors are necessary. The spavin exostosis, the spavin 
lameness, which is very characteristic, the spavin test and 
negative results w^hen examining the rest of the affected quar- 
ter. The only one of these symptoms that might vary is the 
spavin exostosis. The spavin test alone is of no value, for it 
will give the same results in gonitis and coxitis. The diagnosis 
may be made positive in doubtful cases by a cocaine injection 
over the anterior and posterior tibial nerve. 

Pathologically in the region of the joint there is an exos- 
tosis formation, which may be only visible or quite large, or 
there may be an ankylosis of the lower part of the joint. This 
ankylosis very frequently involves the small meta-tarsal bones. 
On cross section the bone is very red and hyperaemic and soft 
in consistency. As a result of this softening there is produced 
a hard firm bony substance, which is known as condensing 
ostitis. The joint cartilage is rough, soft, opaque, and dis- 
colored brownish. There may be small erosions over the entire 
joint surface. 

Prognosis — The prognosis of spavin is variable but on the 
whole quite favorable. A spontaneous healing in spavin lame- 
ness is the most common form of resolution. 

The prognosis of spavin depends upon the age of the lame- 
ness, position and form of the exostosis, the age and the care 
and usage of the animal. If the spavin is of very long stand- 
ing, and the entire leg has become atrophic with a congenital 
joint for spavin, the prognosis is more unfavorable. Also if 
the leg has a faulty position. The prognosis is more favorable 
in a perfect joint, new formed spavin lameness, when the exos- 
tosis is low and the animal can be well taken care of and given 
plenty of rest. 

Treatment — The treatment consists in first of all a long- 
period of rest. If possible the animal should rest at least a 



2o6 The Practice of Veterinary Surgery 

month and as much more as possible. A great many cases 
heal spontaneously in this manner. Along Avith rest the 
animal should be properly shod. A long shoe should be fitted 
to the foot Avith long heel calks and no toe. This seems to 
relieve the pressure and will give very marked relief in spavin 
lameness. Along with rest and proper shoeing, irritating- 
ointments should be applied or the animal should be fired. 
This firing should be of the punctured form and should not 
only cover the exostosis but should extend over and around 
the exostosis. Tenotomy for spavin lameness does not seem 
to give the desired results and in late years has been abandoned. 
Anterior and posterior tibial neurectomy for spavin lame- 
ness should only be resorted to as a last resort. 

Injuries to the Joint and Surrounding Synovial Membranes. 

Injuries to the joint are mainly mechanical injuries, con- 
tusions, etc. In a great many cases open joint is the result. 
Opening of the joint is usually diagnosed by the flow of 
synovia, and a severe acute arthritis is usually the result, with 
death from septicaemia. 

Treatment— The treatment consists in thorough disinfec- 
tion with the application of an occlusive bandage. 

Inflammation of the hock joint is usually the result of 
mechanical irritations, distortions, fractures, luxation and sub- 
luxation, the spread of a suppurative phlegmon or suppurative 
tendovaginitis. This condition may be brought on also by 
pyaemia, septicaemia, glanders, foal lameness and tuberculosis. 
The infection enters the joint by metastasis. 

There are two common forms of arthritis of the hock. 
Acute, aseptic, serous arthritis, and acute suppurative. 

Symptoms — Acute serous arthritis does not dift'er from 
any acute, serous arthritis or phlegmon, but in the suppurative 
there are characteristic symptoms as a diffuse, hot, painful 



The Practice of Veterinary Surgery 207 

swelling of the entire joint very severe lameness, a suppurative 
discharge containing synovia and severe general symptoms. 

This usually leads to death rapidly by a generalized septi- 
caemia or the animal dies from decubital gangrene and sinking 
of the OS pedis. 

Treatment — The treatment is the same as for any sup- 
purative arthritis. 

Inflammation of the Tendon Sheaths in the Region of the Hock. 

Inflammation of the tendon sheaths in the region of the 
hock usually manifests certain symptoms as a long narrow 
swelling, which is firm, hot, and painful, severe lameness and 
if suppurative, there is a discharge containing pus and synovia 
as well as general symptoms. 

Prognosis — The prognosis is favorable if drained and 
properly treated. 

Treatment — The treatment consists in moist heat, mas- 
sage, aspiration, free incision and antiseptic drainage. 

Peri Arthritis of the Hock. 

This is somewhat the opposite condition from spavin. It 
is a diffuse chronic thickening of the entire joint and the tissues 
surrounding it. 

Cause — The causes are primary and secondary. Primary 
causes include fracture, distortion, contusion, over-exertion. 
Secondary causes include the spread of an inflammation, firing, 
arthritis, phlegmon, or the inflammation of the tendon sheaths 
in the region of the hock. 

In this condition the entire joint is affected. The entire 
joint undergoes an ossifying periostitis and exostosis forma- 
tion. As the result of this it becomes enlarged in all directions. 
In some cases it is three or four times as large as the normal 
condition. In severe ossifying exostosis the entire joint under- 
goes ankylosis. The capsular ligament and lateral ligament 



2o8 The Practice of Veterinary Surgery 

become ossified and the skin becomes greatly thickened. The 
skin and connective tissue become adherent. 

Symptoms — Chronic deforming periarthritis is made mani- 
fest by a severe chronic lameness. In the region of the joint 
there are painful swellings, and these give rise to a severe 
lameness. This lameness becomes very severe after the spavin 
test. There is a diffuse swelling of the entire joint which is 
very firm and hot. The skin is not movable over the joint and 
is very tense. The motion of the joint is either lessened by 
the swelling or greatl}^ hindered as the result of ankylosis. 
Animals suffering" from this condition do not lie down, but if 
they fall down it is almost impossible for them to rise again 
and usually they must be helped. 

Prognosis — This condition is incurable, but if treatment is 
properly administered in the early stages, relief may be ob- 
tained to a certain extent. 

Treatment — The treatment consists in moist heat, or cold 
applications with plenty of massage. Usually firing and blis- 
tering increase the trouble. Various cooling liniments seem 
to give results, as white lotion, white liniment, solution of 
ammonium chloride. If the lameness is found to be absolutely 
incurable neurectomy of the anterior and posterior tibial should 
be resorted to. 

Galls in the Region of the Joint. 

A so-called "bog spavin" consists in either a chronic 
hydrops of the tarsal joint or a hydrops of the tend'on sheath 
of the flexor pedis. It is usuall}^ the result of a serous arthritis 
and manifests itself in the form of cold, painless, fluctuating 
areas. One of these appear on the outer and upper aspect of 
the joint, the other on the inner and lower surface of the joint. 
There may also be another fluctuating spot on the lower and 
posterior surface of the joint. If these three swellings are 



The Practice of Veterinary Surgery 209 

present the condition is called "thoropin." These swellings are 
compressible and give rise to no symptoms. They are simply 
blemishes. From a forensic standpoint this is a very im- 
portant factor. 

Treatment — The treatment consists in the application of 
absorbents or a truss. A truss only gives results in acute cases. 
The proper mode of treatment consists in free incision and 
drainage except where it is joint hydTop. Iodine, ether, 
alcohol, and collodion seem to give good results in these cases 
applied externally. 

A hygroma of the tendon sheath of the perforatus is often 
known as thoropin. This condition may become exceedingly 
large in severe cases. It forms a soft fluctuating swelling 
behind and below the joint and outside and somewhat above 
the joint. 

The treatment for this is the same as for bog spavin. 

Capped Hock. 

This is a tumefaction on the point of the hock which is 
generally the result of an injury. This condition may be 
brought on by several causes. 

Cause — A bruising of the skin and subcutaneous tissue 
may give rise to dermatitis, phlegmon, hematoma or a fibrous 
tumor. Bruising the subcutaneous bursa over the os calcis 
may give rise to an acute serous bursitis or bursal hygroma. 

A bruising of the tendon sheath of the perforans or the 
subtendonous bursa of the os calcis may give rise to tendonitis, 
acute and chronic tendo-vaginitis. 

A bruising of the os calcis may give rise to periostitis and 
exostitis formation. 

Symptoms — Any of the above conditions may give rise to 
a common set of symptoms. A new formed capped hock 
appears as a suddenly appearing fluctuating tumefaction which 



2IO The Practice of Veterinary Surgery 

is warm and very soft. As the case grows older it becomes 
more firm, cold and painless. If the swelling is more to one 
side than the other it indicates tendovaginitis. Some acute 
cases give rise to lameness, but older cases never give rise to 
any further trouble than a blemish. 

Prognosis — The prognosis of bruising of the skin is more 
favorable than bruising of the bursae. The prognosis of 
hygroma of the bursae is less favorable, but most cases yield 
to treatment quite readily. 

Treatment — In acute cases the treatment consists in moist 
heat, massage and rest, also the application of various irritating 
liniments. In older cases it is usually a hygroma and iodine 
preparations should be used. Painting the entire surface with 
a thirty-three per cent solution of iodine crystals in alcohol or 
iodine crystals, alcohol, ether and flexible collodion. The 
radical treatment consists in casting the animal and removing 
the entire synovial sack. If it cannot be removed with a knife 
it may be curretted and a strong tincture of iodine applied to 
destroy the capsule. Aspiration is contra-indicated for in 
practice the results have not proven satisfactory. 

Curb. 

This is a peculiar swelling which appears on the posterior 
surface of the hock and metacarpal bone. This is only seen 
from a side view. It may be caused by a variety of conditions. 

An inflammation of the perforans, from a contusion (a 
so-called bony curb), is the result of a contusion from which 
there arises an exostosis. A periostitis in this region or a 
chronic inflammation of the capsular ligament may give rise 
to this symptom. 

A congenital curb consists in a chronic weakness of the 
joint. It is a malformation and has the appearance of a curb. 
From a practical point of view there are two forms that need 



The Practice of Veterinary Surgery 211 

treatment. First a curb due to tendonitis and secondarily a 
curb due to periostitis with exostosis formation. 

Cause — The cause of tendonitis in this region is contusion, 
over-exertion or straining. 

Symptoms — The symptoms of this form of curb are acute 
inflammation and lameness. This swelling is very painful and 
is either soft or fluctuating. After this becomes older the 
swelling becomes harder, colder and more painless. The cause 
of this condition is usually acute with a resorption and healing 
or a chronic thickening left over. This chronic thickening may 
give rise to a contracture with the formation of stiltfoot. 

Treatment— The treatment of the acute form consists in 
moist heat, irritating and stimulating liniments. After the 
acute symptoms have subsided blistering and firing may be 
resorted to. Line and feather firing are preferable. If point 
firing is used, the points should not be punctured through the 
skin. A chronic thickening may be removed without firing by 
the use of iodine ointment thirty-three per cent or tincture of 
iodine thirty-three per cent, or iodine crystals, collodion, ether 
and alcohol. 

Bone curb is the result of a chronic ostitis, periostitis or 
periarthritis in the region of the lower and posterior part of 
the joint. It is not a commonly appearing condition, but does 
appear at times as the result of over-exertion and contusion. 
The swelling which arises as the result of this injury is hard, 
appears to be chronic and causes very severe lameness. 

Prognosis — The prognosis is xery unfavorable and should 
be treated the same as spavin. 

Stringhalt. 

Stringhalt is a peculiar, involuntary jerking of one or both 
hind feet while the animal is in motion, during the act of 



212 The Practice of Veterinary Surgery 

flexion. The leg is suddenly flexed and jerked up in the air. 
This condition must not be confused with the so-called 
"cramp," which is seen by making the animal step over in the 
stall. The cause of this motor disturbance of locomotion is not 
known. However, it appears in two forms, symptomatic, and 
true stringhalt. 

Cause — Symptomatic stringhalt is the result of some pain- 
ful affliction of the hind leg and is looked upon as being purely 
reflex. It is known to accompany spavin and habitual luxation 
of the patella, and occurs after neurectomy in which there is a 
painful cicatrix formed during the process of healing, after 
treads on the coronet, nail puncture and scratches. 

Idiopathic stringhalt is probably some form of ataxia, but 
this has never been proven. Some authors seem to think it is 
due to neuritis or some other form of chorea. 

Treatment — The treatment consists in perineal tenotomy. 
In about sixty-five per cent of all cases this seems to give 
results. The more the hock is flexed and the greater the 
jerking, the more readily the disease is curable. The operation 
should be performed below the hock first and if it reappears 
or does not respond operate above the hock. 

Inflammation of the Tendon Sheaths of the Fetlock and Foot. 

Inflammation of the tendon sheaths in the region of the 
fetlock and foot present identical symptoms of acute serous 
bursitis and hygroma. 

The treatment is the same. 

DISEASES OF THE HOOF. 

Podo-dermatitis. 

According to the cause podo-dermatitis may be classified 
as aseptic and septic. The aseptic form exists without the 



The Practice of Veterinary Surgery 213 

presence of bacteria and is due to injuries and traumatisms, 
traveling on the hard roads and in some cases burning with a 
hot shoe while fitting. It may also be brought on by applying 
a severe blister around the coronary band. 

The septic form is due to the entrance of bacteria. These 
enter most commonly through a wound but may be carried 
there by the blood stream. 

According to the cause it is aseptic and septic, according 
to the grade superficial and deep, according to the size it may 
be circumscribed or dififuse. From a practical standpoint the 
following are the most important: Acute, non-suppurative, 
chronic hyperplastic, suppurative and necrotic. 

Acute non-suppurative podo-dermatitis consists in a 
serous, sero-fibrinous or sero hemorrhagic inflammation of the 
pododerm, with the thickening of the pododerm. 

Suppurative Podo-dermatitis. 

Cause — The most common cause of this condition is a 
wound to the pododerm with an infection. It usually occurs 
after pricking, treads on the coronet, suppurating corns and 
seedy toe. 

Symptoms — A superficial suppurative inflammation of the 
pododerm is usually circumscribed and is characterized by the 
formation of a thin serous exudate. The exudate infiltrates 
the pododerm causing it to become swollen. The most char- 
acteristic S3'mptoms are a very painful lameness, the entire 
foot becoming hot and an increased pulsation in the digital 
arteries. By percussion with a pair of hoof tongs the animal 
shows great pain. The coronary band and bulb of the heel 
become greatly swollen and finally discharge pus. After the 
discharge of pus, the swelling subsides and healing takes place 
very rapidly. 



214 ^^^ Practice of Veterinary Surgery- 

Treatment — The treatment consists in free incision 
through the horny wall with disinfection and bandaging. This 
pus may discharge and the wound heal spontaneously. 

A deep suppurative inflammation of the pododerm usually 
involves more of an area of the pododerm and is also circum- 
scribed. This form is characterized by the formation of a 
thick creamy pus. This form usually appears in the form of an 
abscess or suppurative phlegmon in the region of the coronary 
band or the bulbs of the heels. The pus may also' undermine 
the sole and cause a separation in the wall. This condition 
leads to a very severe lameness, which does not disappear after 
the pus has been removed. This form leads to the formation 
of a fistula and quittor, necrosis of the pododerm, os pedis, 
perforans tendon, and suppurative arthritis. Eventually this 
condition may lead to septicaemia and pyaemia. 

Treatment — The treatment consists in excision and cleans- 
ing as well as removal of the necrotic parts. This should be 
followed by careful disinfection. 

Laminitis. 

Laminitis is a diffuse aseptic inflammation of the podo- 
derm which occurs in both front feet most commonly, but may 
appear in all four feet. 

This inflammatory process involves the pododerm of the 
toe, side wall and sole. 

According to the cause there are the following forms of 
laminitis: Due to traumatic injuries, due to injudicious feed- 
ing, and symptomatic. 

Cause — Traumatic laminitis is caused by severe work, 
over-exertion, fast work on hard roads, forced marches, driving 
on rough uneven roads, by standing on a hard surface, by 
suddenly cooling off or by shoeing. Some animals seem to 



The Practice of Veterinary Surgery 215 

have an individual predisposition to laminitis. Lymphatic 
sluggish horses seem to be especially predisposed. 

Laminitis frequently follows indigestion, faulty feeding, 
over-feeding or some fault with the diet. It occurs especially 
after the animal has been fed great quantities of grain. The 
supposition is that it gives rise to an auto-intoxication with 
laminitis as the result. 

Rheumatic laminitis, or so-called air founder, occurs as 
the result of sudden chilling of the body after a long exhaust- 
ing drive, or after it has been quite hot. 

Symptomatic or metastatic laminitis appears as a secon- 
dary disease and accompanies this disease or appears as a 
symptom in the course of the disease. It follows difficult par- 
turition where inflammation of the uterus exists or it may 
appear as a symptom during the course of influenza or con- 
tagious pleuro-pneumonia. 

Symptoms — The symptoms are divided into acute and 
chronic. Acute laminitis manifests itself through a suddenly 
appearing lameness which usually attacks the forefeet. The 
feet are placed as far forward as possible and the hind legs 
are also drawn under the body. This is done so that the body 
weight may be thrown on the hind feet, thus relieving the front 
feet. The gait is short and painful, the entire body is stifif and 
the animal walks as though it were tramping on nails. The 
foot is not placed flat on the ground but the heels touch first 
and bear most of the weight. In severe cases it is often im- 
possible to move the animal from the spot it stands on. 

By local examination the foot is found to be quite warm, 
very severe pain is caused by tapping the feet or pressure with 
a tong. There is very noticeable pulsation in the digital 
arteries. There may or may not be some general symptoms 
present. In most cases there is a slight fever, loss of appetite 
and constipation. 



2i6 The Practice of Veterinary Surgery 

The course of acute laminitis is short, usually lasting 
from four to ten days with complete recovery. Sinking of the 
OS pedis is very uncommon following acute liminitis, but has 
been known to occur. Metastatic septicaemia has been known 
to follow acute laminitis with fatal results but is very uncom- 
mon. 

Chronic laminitis is usually the result of an acute attack 
being very severe or not being properly treated. The symp- 
toms of chronic laminitis are mainly changes in the hoof and 
loot structure. A serous exudate is thrown out between the 
sensitive and horny laminae in the acute stages. This leads to 
a separation in very se\ere cases. After there has been a 
separation the weight of the body is borne by the perforans 
tendon. The tendon pulls up and back and as a result the 
point of the os pedis is pulled down, because the laminae have 
been separated and can no longer support weight. As a result 
of the foot being unable to bear the weight of the body and 
the OS pedis turning down, the sole becomes flattened out and 
apparently sinks. As a result of the sole sinking, the entire 
structure is lowered and there is marked sinking of the coro- 
nary band. The coronary band becomes disturbed and irri- 
tated, and rings develop in the walls of the hoof. These rings 
are not e^■en and smooth, but are larger in front and diverge 
toward the heels. The coronary band has a marked dip in it 
on the toe wall and the white line is very broad. The toe of 
the foot is greatly thickened, and the gait of the animals is 
peculiar, short and A'cry painful. 

Prognosis — The prognosis of acute cases is generally gooci 
but should be guarded. 

Treatment — The treatment in acute laminitis should be 
radical. First phlebotomy should be resorted to, at least one 
gallon of blood per thousand pounds should be drawn. This 
should be followed by one-half grain arecoline every hour for 
three hours. The animal should have the affected feet placed 



The Practice of Veterinary Surgery 217 

in cold water or packed in ice, or packed with cold white rock. 
The animal should not be allowed to eat anything for at least 
two days, and after this it should be given soft laxative diet, 
as mashes. Diuretics are also indicated as formin in thirty 
grain doses, turpentine in drahm doses, or one pint of coffee 
morning and night. The main treatment consists in laxatives, 
phlebotomy and cold to the feet. 

The animal should be shod with a very wide shoe and 
bring as much pressure on the bars and frog as posisble. In 
cases of chronic laminitis, shoeing is the only agent that will 
give relief. Blistering and firing the coronary band may give 
results that are of doubtful value. Neurectomy should never 
be performed in these cases. 

Nail Puncture. 

By nail punctcure is meant the entrance of a nail or a 
sharp painted object through the sole of the foot, into the 
internal structure of the foot. The nail may puncture the 
pododerm, fatty frog, perforans tendon and the os pedis. 

Punctures to the pododerm result in a circumscribed 
superficial or deep suppurative pododermatitis. 

Symptoms — The symptoms are hemorrhage, suppuration, 
lameness, and a circumscribed painful area, found by palpation. 
The foot may or may not be warmer than normal. As a rule 
by proper treatment these cases make a nice recovery, but they 
may result in tetanus, necrotic pododermatitis, or any specific 
wound infectious disease. 

Treatment — The treatment consists in free drainage, thor- 
ough disinfection by means of soaking and an occlusive 
bandage. 

Puncture of the fatty frog usually leads to circumscribed 
or diffuse abscess formation or necrosis, 

IS 



2i8 The Practice of Veterinary Surgery 

Symptoms — The symptoms consist in a canal from which 
a bloody or suppurative exudate is discharged. The walls of 
this canal are covered with granulations which are greyish in 
color. Phlegmon of the fatty frog from nail puncture consists 
in swelling, serous infiltration and a greyish discoloration. In 
cases of necrosis of the fatty frog the area is greenis'h in color. 
The clinical symptoms of phlegmon consist in a painful swell- 
ing which is hot, the bulbs of the heels are greatly swollen 
and the animal is very lame. 

Treatment — The treatment consists in free incision and 
thorough disinfection of the canal. If the necrosis becomes 
very severe it may become necessary to remove a part or all 
of it. 

Puncture of the bursa podo-trochlearis and the perforans 
lead to suppurative bursitis and necrosis of the perforans. 

S5niiptoms — The clinical symptoms of suppurative bursitis 
consist in severe swelling in the region of the heels and coro- 
nary band, severe pain on dorsal flexion and volar flexion 
causes supporting leg lameness. Necrosis of the perforans 
tendon is characterized by a greenish exudate and small pieces 
of tendon in the discharge. There is a canal which leads to the 
tendon and discharges an icteric or suppurative discharge. 
This is accompanied by a phlegmon of the fatty frog and very 
high grade lameness by volar flexion. If the case becomes 
very severe there may be a phlegmon of the entire foot and 
the structure surrounding it. The most diagnostic symptom is 
the fact that dorsal flexion causes great pain. In this condi- 
tion there are severe general symptoms, rapid emaciation, 
anorexia and sinking of the os pedis in the opposite foot. This 
condition is frequently complicated with suppurative podo- 
arthritis. 

Treatment — The treatment consists in resection of the 
perforans tendon. This operation should be performed as 
early as possible after .the diagnosis has been made. In resec- 



The Practice of Veterinary Surgery 219 

tion of the tendon it is usually wise to remove the fatty frog' 
and as much of the tendon as possible. An Esmarchs bandage 
should be applied in the region of the fetlock to prevent exces- 
sive hemorrhage. After as much of the tendon as possible has 
been removed, it is well to curette the entire area and apply 
iodoform ether freely. Allow this to remain for a few minutes, 
then thoroughly curette the entire area. After this apply 
iodoform ether and apply an occlusive bandage. The wound 
may be packed with iodoform gauze in preference to iodoform 
ether. This occlusive bandage may be left in position until 
there is a rise in body temperature indicating absorption of 
wound products. If the temperature does not rise the bandage 
should be changed in ten days. After the third day there is 
very little danger of absorption on account of the formation of 
granulation tissue. 

Punctures of the os pedis and os suliraginis usually lead 
to fracture and as a general rule are incurable. Puncture and 
fracture of the os pedis is somewhat harder to diagnose. A 
puncture of the os pedis may be either partial or complete, 
depending on the parts punctured. There is a canal which 
discharges freely. Frequently after an aseptic puncture there 
is a chronic lameness left over which lasts for months. 

Puncture of the coffin joint usually leads to septicaemia 
and death. There is developed an acute suppurative arthritis. 
It is made manifest by a circumscribed swelling around the 
coronary band and other symptoms of septic arthritis. 

Nail Prick. 

Nail prick is a condition in which the nail pierces the 
pododerm, fatty frog, or the sensitive laminae and sole par- 
ticularly. A direct pricking takes place by the smith driving 
a nail directly into the pododerm. An indirect pricking is a 
bruising of the pododerm by the nail coming too close to it. 
As a result of direct pricking, suppurative podo-dermatitis or 



220 The Practice of Veterinary Surgery 

necrosis of the pododerm may follow. The indirect pricking 
or pressure is usually aseptic and does not have these after 
affects. 

Cause — The causes of pricking are nailing too deeply, 
nailing and drawing the shoe too tightly, not driving the nail 
through the white line, rasping and paring the foot too thin, 
steep walls, etc. 

Symptoms — The first noticeable symptom is great pain in 
the region of the foot affected. The animal shows great pain 
by walking on the affected foot. If the nail is drawn, usually 
a small amount of blood will ooze from the nail hole. It may 
also occur that this lameness does not appear at once, but does 
appear after three or four days. After a few days there are 
symptoms of suppurative pododermatitis, heat and pain on 
pressure and tapping, pus and blood are discharged from the 
nail hole. Abscesses may form around the coronet. In severe 
cases the pricking is usually associated with a fracture of the 
OS pedis and necrosis of the pododerm. Tetanus may result as 
a wound infectious disease. 

Treatment — Make a free incision, drain and irrigate by 
soaking for hours at a time. Use your antiseptics as formal- 
dehyde or bichloride. 

Corns. 

By this term is designated a bruising or contusing of the 
pododerm, which is seen in the region of the bars of the foot. 
Commonly they are hemorrhagic, aseptic pododermatitis, but 
may be a suppurative pododermatitis of the sole. 

Cause — The causes of corns are bruising and contusing 
the feet, from paring too closely, faulty showing and faulty 
position of the foot, using hind shoes on front feet, cutting 
away of the bars and narrow heels predispose to this condition. 



The Practice of Veterinary Surgery 221 

Symptoms — The symptoms are seen most commonly on 
the inside of the foot. There is lameness present and upon 
examination of the foot there is a hyperaemia and hemorrhabic 
pod'odermatitis. As a result of this there are red and bluish 
red spots seen in the sole of the hoof at that point. These are 
known as dry corns. If the contusion is very severe, pus 
forming bacteria enter the pododerm and give rise to the 
formation of pus. This leads to subcoronary phlegmon, 
abscess formation around the coronet and eventually may lead 
to a quittor formation. 

Treatment — The treatment consists of proper paring of 
the foot and proper shoeing. 

Quittor. 

Quittor consists in a necrosis of the lateral cartilage. 
This is brought about by a para-chondral phlegmon, a suppu- 
rative phlegmon of this region of the foot, suppurative podo- 
trochlitis, suppurative corns, treads on the coronet, nail punc- 
ture and ecdema. 

Cause — Suppurative corns cause quittor by the spread of 
the inflammatory process to the cartilage. Quittor nearly 
always makes its appearance on the inside of the foot, and 
corns also make their appearance in this region. Treads on 
the coronet cause quittor in this way also, or the infection is 
brought in direct contact with the cartilage itself. 

Symptoms — The first symptom noticed is a para-chondral 
phlegmon, which is a firm painful swelling around the coronary 
band. Then there is a small opening which forms in the region 
of the heel, and discharges a thin pus. This opening is usually 
small, round and contains abnormal granulations at its opening. 
There may develop several openings after the disease has run 
for several weeks. These fistulous canals may heal leaving 
behind them an unsightly cicatrix, which causes a deformity 



222 The Practice of Veterinary Surgery 

in the wall of the foot. When the case is in the early stages 
there is lameness, but after it becomes chronic lameness fails. 
The cartilage becomes green in color and the sequester is 
usually leaf form and covered with greyish or reddish granula- 
tions. This sequester may be free or partly attached to the 
cartilage. As a rule there is more than one necrotic spot on 
the cartilage. The fistulous canals may or may not be probed. 
They may be straight or bending. 

Prognosis — The prognosis as a whole is somewhat un- 
favorable and should be made only with great care. Some 
quittors are easily curable while others are incurable. 

Treatment — The main treatment consists in caustics and 
the radical operation which consists in resection of the lateral 
cartilage. Disinfection without caustics proves almost useless. 
Zinc chloride and formaldehyde seem to give the best results. 

Side Bones. 

This is an ossification of the lateral cartilage. This con- 
dition is seen most commonly in heavy horses. This ossifica- 
tion occurs as the result of a chronic ostitis of the os pedis or a 
traumatic inflammation of the lateral cartilage or a primary 
chondritis. 

Cause — The cause of these conditions is a constant irrita- 
tion produced by hard usage on paved streets. Any abnormal- 
ity of the foot acts as a predisposing factor. Usually side bones 
and splints develop at the same time. 

Symptoms — Side bones do not give rise to any inflamma- 
tory condition after they have formed. During the process of 
formation they may give rise to an acute inflammatory lame- 
ness. This lameness is typical supporting leg lameness, which 
gets worse on motion and better after a long period of rest. 
If there is any lameness present after the side bones have been 



The Practice of Veterinary Surgery 223 

formed, it is due to a contusing of the soft parts of the foot as 
a result of the non-elasticity of the cartilages. The most com- 
mon complication is a peri-arthritis with the podo-arthritis. 

Treatment — The treatment of side bones is practically- 
worthless. In the acute stages while it is undergoing ossifica- 
tion, blistering agents may be used as well as actual cautery 
to hasten the process of ossification. Along with this a long 
period of rest is necessary. The period of rest is probably the 
most important thing in the treatment and other things are 
secondary. Shoeing with plates is also a very important factor, 
or shoeing so as to relieve the pressure on the quarter will 
also give relief. 

Thrush. 

Ordinarily thrush consists in gangrene of the horny frog. 
This gangrenous process may extend to the heels and eventu- 
ally on to the skin giving rise to symptoms of scratches. 

Symptoms — The symptoms of thrush are tenderness in 
the gait and eventually lameness with a very foul discharge 
from the clefts of the frog and heels. This condition may 
result in an entire disintregation of the frog. 

Treatment — The treatment consists of drying agents and 
antiseptics. Calomel powdered into the clefts and then band- 
aged is quite satisfactory. Formalin is probably the most 
satisfactory agent, as this dries and hardens at the same time. 
Some authorities advocate the use of coal tar antiseptics and 
muriatic acid. However, these are not as satisfactory. 



CHAPTER VII 

SURGICAL DIAGNOSIS 

History. 

THE history of the case is obtained either from the owner 
or from the person having charge of the animal. The 
history of the case is just as important for a surgical 
diagnosis as for any other diagnosis. A careful anamesis is 
half a diagnosis in surgery. The most important questions to 
be asked are : 1. The cause of this lesion. 2. Length of dura- 
tion. 3. What has been the previous treatment? 4. How 
did it happen? 5. In case the animal is lame, where was this 
injury received, in the stall, on the street, in the blacksmith 
shop, etc. If the animal was injured on the street it is usually 
a nail puncture or a contusion. If the animal goes lame after 
leaving the blacksmith shop, you are inclined to think of nail 
prick. While these questions are being asked the affected 
parts should be palputed with the fingers. The diagnosis can 
usually be made by the history. 

If a tumefaction is present and the history of the case 
indicates that it has arisen spontaneously and without appar- 
ent cause, a tumor may be suspected. 

Next, the length of existence of this lesion. How long 
has the animal been affected? Has this lesion arisen suddenly 
or has it come on gradually? The answer to this question will 
designate whether it is acute, subacute or chronic. 

A suddenly appearing lameness would indicate distortion, 
tendonitis, myositis or a fracture, or any complication of these 
four conditions. 



The Practice of Veterinary Surgery 225 

If the lameness has been getting worse gradually and is 
practically chronic, it would indicate a spavin, ringbone, 
chronic podotrochlitis, or any complication of these conditions. 

If the animal had received an injury in the region of the 
buttock and a suddenly appearing tumefaction has arisen it 
would indicate a hematoma or a complication of a hematoma. 
If this tumefaction was slow in developing it would indicate a 
phlegmon, an abscess or a new formation. 

The next question that arises is, is this lameness constant 
or does it grow less or more severe on exercise? If the lame- 
ness is remittant, it must be rheumatic in origin, or a thrombus. 
If the lameness grows graduall}' better it would indicate a 
spavin. If the animal does not appear lame after a long period 
of rest, and then on exercise gradually the lameness appears, 
it would indicate the presence of ringbone, chronic gonitis, 
omarthritis or podotrochlitis. If a condition exists that is the 
opposite to spavin lameness it would indicate the presence of 
distortion, or a complication of distortion. 

By whom was the animal treated? If the treatment has 
been administered by the owner, a false diagnosis may have 
been made, and even then, a present diagnosis must be made. 

Examination. 

Has a rectal examination been made? The special exam- 
ination should first be made by makmg a general examination 
of the animal. Watch the animal move, take note of sex, age, 
color, general constitutional vigor and temperament. From a 
legal standpoint it is always advisable to make an exact 
memorandum of each examination. 

In warm-blooded horses, especially in saddle horses, we 
find a degeneration of the bones and muscles, and when these 
animals are cast, they are subject to fractures. 



226 The Practice of Veterinary Surgery 

In warm-blooded horses we see the disease which is known 
as roaring appearing most commonly. This is not noticed so 
much in phlegmatic horses. 

Warm-blooded horses are more apt to become paralyzed 
after an operation than phlegmatic horses. 

Cold-blooded animals are not as susceptible to chronic 
podotrochlitis. 

Cold-blooded animals are more susceptible to the forma- 
tion of side bones. 

Warm-blooded animals are far more susceptible to tendo- 
nitis than cold-blooded animals. 

In cold-blooded animals the perforans tendons are most 
commonly affected while in warm-blooded animals the per- 
foratus or suspensory is most likely to be affected. Cryp- 
torchidy appears most commonly in cross-bred and cold- 
blooded animals. 

Horses are more susceptible to affections of tendon sheaths 
and joints than mules and donkeys. 

Suppurative arthritis and tendo vaginitis seems to run a 
much milder course in mules than it does in horses. 

The Age of the Animal. 

In diagnosing a tumefaction the age of the horse is a most 
important factor. 

Old horses are very susceptible to carcinomatous and sar- 
comatous growths. Old horses suffer more from cataract than 
young horses, and are more susceptible to secondary hemorr- 
hages than young horses. Fractures are more common in old 
horses than in young horses. Wounds heal more rapidly in 
young horses than in old horses. Old stallions are very apt 
to suffer from an adhesive periorchitis. 

Sex. 

Stallions suffer most frequently from hernia. Every case 
of colic in a stallion should be looked upon with suspicion and 



The Practice of Veterinary Surgery 227 

a thorough examination of the scrotum should be made for 
hernia. Geldings are more susceptible to calculi in the bladder 
than mares. 

Color. 

New formations in gray horses are usually melanotic in 
origin, especially in the region of the head and tail. Grey 
horses are very apt to become aflfected with diseases of the eye, 
especially those of the iris and crystaline lens. Animals 
having white skin are more subject to dermatitis and ery- 
threma than those having a pigmented skin. 

Weight. 

The weight of the animal is important from a standpoint 
of dosage. 

Large, heavy, fat horses are more apt to suffer from 
myositis, haemoglobinaemia and azoturia than smaller and 
thinner horses. 

Very heavy horses are more apt to suffer from a sinking 
of the OS pedis. 

Constitution. 

The general constitution of tlie animal influences wound 
healing. 

The temperament must always be considered before an 
operation. Phlegmatic horses can usually be operated on in 
the standing position. Warm-blooded horses must be cast as 
a general rule. 

Inspection. 

This is carried on with the hands and the eyes. The first 
thing is to locate the diseased condition. This should then be 
compared with the opposite part of the body. The size, form, 
color and general condition of the lesion are the points to be 
considered. In considering the individual part, first locate the 



228 The Practice of Veterinary Surgery 

topographical anatomy of that part. If the topographical 
anatomy of the part is understood a diagnosis can be made 
easily. The exact place, position and location of the lesion 
must be ascertained. 

The size of the lesion is to be inspected. This size is 
important from a forensic standpoint and should be obtained 
by measuring with an accurate line. The form of the lesion 
inspected should be taken into account. 

Wounds, cuts, new formation, etc., have a variety of forms. 
They may be round, oval, cylindrical, elliptical, or they may 
be compared with various objects. The color should also be 
taken into consideration, especially of wounds of the skin and 
mucous membrane. In certain forms of ulcerations a cancer 
can be diagnosed very often by the color of the exudate. 

A suppurative nasal discharge usually indicates empyema ; 
a greenish nasal discharge, which is foul smelling, generally 
indicates necrosis. The internal administration of various 
drugs will often change the color of the natural secretion. 

The skin over an abscess that has become necrotic is 
bluish in color and this may be looked upon as a diagnostic 
symptom. 

Necrosis of the skin is usually black, brown or lead color, 
while necrosis of the living tissue is yellowish in color or a 
light green. This is especially true of fistula, necrosis of the 
tendon, and necrosis of the pododerm. (These do not vary a 
great deal.) The antiseptic agent used may change the color 
of the exudate. A brownish color may be obtained by using 
iodine; a yellowish color is obtained by cantharides, etc. 

A wound should be examined externally in regard to the 
condition of granulation tissue, whether it is deficient, exces- 
sive, or abnormal in any other respect. The surface of the 
wound may be covered with blood, lymph, pus or a slimy 
exudate. 



The Practice of Veterinary Surgery 229 

Healing by First Intention. 

This is the immediate agglutation of a wound surface 
without suppuration. To have this, the edges of the wound 
must be brought in direct apposition, the entire wound must 
be entirely aseptic, all foreign bodies must be removed. 

Healing by Second Intention. 

Healing by second intention is healing by excessive granu- 
lation and suppuration. 

The properties of granulation tissue (why granulation 
tisvsue forms). 

To make up for the loss of substance, to mechanically seal 
the lymph vessels and to protect the blood stream from the 
absorption of bacteria and their toxins. 

Palpation. 

Palpation consists in manipulating the part by the hand 
to ascertain the temperature, the consistency, the motion, the 
compressibility and whether or not there is any crepitation 
present. 

The probang may be used as a special means of palpation, 
and the catheter to examine the nasal cavities. 

Temperature. 

The temperature of the affected part is obtained by laying 
the hand on the part. An elevation of temperature in a part 
would indicate an acute inflammatory process, while a sub- 
normal temperature would indicate necrosis or anaemia. 
Abcesses, phlegmon and dermatitis are usually accompanied 
by an elevation of temperature. The so-called cold abscess is 
not accompanied by acute inflammatory symptoms. 



230 The Practice of Veterinary Surgery 

Sensibility. 

Sensation in the part is determined by pressure or pin 
prick, an increased sensation in a part indicates an inflam- 
mator}^ condition. The lessening of the normal sensation 
indicates necrosis or a paralysis of the peripheral or spinal 
nerves. Increased sensation can be located by pressing, bend- 
ing, stretching, abduction, or rotation. In chronic arthritis, 
ringbone, and spavin diagnostic palpation is of no importance. 
For these diseases there is a special variety of palpation. 

Consistency. 

As to the consistency of a new formation, note whether it 
is solid, firm, soft, flexible, hard or immovable. The con- 
sistency of a new formation may vary from a watery exudate 
to a firm cheese-like mass. Fluctuation is a diagnostic symp- 
tom in abscess, hematoma and hydrops. Pseudo-fluctuation 
of false fluctuation may be noticed in various forms of soft 
cancerous growths, especially in carcinoma. A stagnation 
oedema should not be confused with fluctuation. In stagna- 
tion oedema finger prints can be noticed in the swelling (pitting 
on pressure, diagnostic symptoms). 

Crepitation. 

Crepitation is determined by palpation and is a peculiar 
rubbing or grinding sensation which is felt in the tissues. 
Crepitation usually indicates a fracture of a bone and is de- 
termined by manipulating the leg manually, moving the animal 
back and forth, or by rotating. Crepitation can also be heard 
as well as felt. Pseudo-crepitation or false crepitation sounds 
like the crunching of a snow ball, and usually designates 
fibrinous arthritis, fibrous bursitis, or fibrous tendovaginitis. 
It also appears in chronic gonitis and in an organizing hema- 
toma. This pseudo-crepitation is not hard and rough like the 



The Practice of Veterinary Surgery 231 

crepitation of bone but sounds something like crepitation 
of bone. In emphysema the crepitation sounds like crush- 
ing paper under the coat. It is noticed in septic emphysema 
and gas phlegmon (malignant oedema, black leg). This form 
of emphysema is soft and may be compared to pressing a 
feather and is due to the formation of gas in the subcutaneous 
tissue. It may be distinguished from bone crepitation because 
it is on the surface. Crepitation must be further distinguished 
from compression of a new formation. 

Abnormal Movement. 

Abnormal movement of a part may be seen as well as felt. 
Abnormal movement of a leg usually indicates fracture, luxa- 
tion, subluxation, rupture of a tendon or muscle. Abnormal 
motion of the tail, penis, ears and tongue are usually due to 
some nervous derangement causing paralysis. 

Compressibility. 

Every new formation should be examined for compressi- 
bility by exerting pressure on the part. It may be either 
partially or momentarily compressible. Compressibility of a 
new formation or tumefaction usually indicates a hernia. Com- 
pressibility must be distinguished from pressure. An oedema- 
tous condition may be compressed but will not return to normal 
when the pressure is released. 

Pulsation. 

Pulsation and increased pulsation in a part usually indi- 
cate an acute inflammatory process. Certain tumors pulsate 
(angioma, goitre if it contains aneurism) and an aneurism can 
be located by pulsation. 

Probing. 

The reason for probing is to find the depth, position, edges, 
as well as direction of a wound or fistulous canal. The most 



232 The Practice of Veterinary Surgery 

useful thing is the finger, and various other things as metal 
probe, catheter, soft probe and teat tube are used. Probing 
is indicated in fistula, quittor, scirrhous cord, bone fistula, 
fistula of the withers, all deep wounds, especially of the mus- 
culature, nail wounds, pricks, treads on coronet or any suppura- 
tive condition of the foot. 

Special forms of probes for probing are the probang for 
the oesophagus, the catheter for the urethra, the teat tube for 
the teat canal, the milk fever apparatus for the lachrymal duct. 

Probing is contra-indicated in fresh or newly-made per- 
forating wounds, of tendon sheaths, wounds in the region of 
the abdomen, the thorax and is not necessary in shallow 
wounds. Perforating wounds into a body cavity should never 
be probed under any circumstances. Probing is also contra- 
indicated in suppurative perforations of joints, tendon sheaths, 
the abdomen or the thoracic cavity. Body cavities should not 
be probed because a new canal or a new phlegmon might be 
started or a wound which is not perforating may be made per- 
forating. 

Percussion. 

Surgical percussion is brougth about with a surgical per- 
cussion hammer, a blacksmith's hammer or the fingers. 
Emphysema, hydrops, as well as new formations of the sinuses 
may be located by percussion. If any of these conditions are 
present their will be a tympanitic tone present on percussion. 
Percussion of a hernia also has a tympanitic tone. In cases of 
pneumo-thorax, perforating chest wounds and sometimes frac- 
ture of the ribs, etc., a tympanitic tone may be heard on per- 
cussion. 

Ausculation. 

Crepitation of a fracture may be ausculated or it may be 
heard more easily than it can be felt. By ausculation the 
stenotic tone will determine whether the stenosis is present at 



The Practice of Veterinary Surgery 233 

the nose, trachea, bronchial tubes or larynx. In a hernia also 
the peristaltic movement can be heard. In otorrhoea a sound 
will be heard on palpation which sounds like the crunching of a 
snowball. Very frequently after castration a peculiar 
gurgling sound may be heard, caused by air entering the 
abdominal cavity. This is of no consequence and should be 
looked on as harmless. 

DIAGNOSTIC OPERATIONS. 

Puncture. 

Puncture is indicated if a tumefaction cannot be definitely 
diagnosed. A horse trocar may be inserted into the tumefac- 
tion to examine the contents and is absolutely a harmless 
operation if asepticaliy performed. This is used to differentiate 
between an abscess and a hematoma, empyema of a tendon 
sheath, empyema of a joint, empyema of a guttural pouch, 
hernia or hydrocele. 

Cocaine Injections. 

Subcutaneous cocaine injections are used to temporarily 
relieve lameness for the sake of diagnosis, in navicular disease, 
articular ringbone, peri-articular ringbone, spavin and such 
diseases. Cocaine injection is a very valuable prognostic agent 
before neurectomy and should always be used before the opera- 
tion is performed, although in some cases the results of a 
cocaine injection are negative while the operation itself will 
give positive results. 

Trepanation. 

Trepanation and exploring is always done with a small 
automatic drill to locate new formations, hydrops, empyema, 
etc. Trepanning should also be resorted to in examining the 
nasal cavity for new formations, foreign bodies, etc. 
16 



234 The Practice of Veterinary Surgery 

Extirpation. 

Extirpation of a, maxillary lymph gland is of diagnostic 
value, when the diseased process in the region of the head is 
due to glanders, secondary sarcoma, botryomycosis, actinomy- 
cosis and corcinoma of the nasal cavity or the sinuses. 

Resection. 

Resection of the perforans tendon should be resorted to, 
to diagnose necrosis of the perforans tendon, suppurative podo- 
arthritis, suppurative arthritis, as well as fracture of the bones 
of the foot. These conditions are usually the result of nail 
puncture. 

Special Diagnosis of the Eye. 

In making an examination of the eye, use a mirror and 
some diagnostic medicinal agent as atropine. In making a 
diagnosis, use three to five drops of a three per cent solution 
of atropine fifteen minutes before examination. 

The lids are examined from the outside in. 

Eyelid. 

If the eyelids are closed, it indicates a fear of light 
(photophobia). This is seen as a symptom in all painful affec- 
tions of the eye. Photophobia would indicate the presence of 
conjunctivitis, keratitis, iritis, periodical ophthalmia, or foreign 
bodies under the lid. A painless drooping of the upper lid 
indicates paralysis. This is commonly known as ptosis and 
accompanies facial paralysis. If the eyelids are abnormally 
wide apart it may indicate a prolapse of the bulb or hydrop- 
thalmus. Swelling of the eyelids usually indicates blepharitis, 
conjunctivitis, phlegmon, new formations, as well as suppura- 
tive panopthalmia. If the lids are abnormally thin with an 
increase in the folds it would indicate atrophy of the bulb. 



The Practice of Veterinary Surgery 235 

If the edge of the eyelid along" with the hair is turned inward 
of against the cornea, it indicates the presence of entropion 
(inversion of the eyelid). If we have the edges of the eyelid 
turned out, it indicates the presence of ectopion (eversion of 
the eyelids). 

The discharge from the eye is very diagnostic. A serous 
discharge from the eye is noticed in all painful affections of 
the eye, as catarrhal conjunctivitis, foreign bodies, in the 
closing of the lachrymal duct, and in the first stages of dis- 
temper and moonblindness. The discharge from the eye 
assumes the nature of mucous in catarrhal conditions of the 
lid. The discharge from the eye becomes suppurative in 
purulent keratitis, purulent conjunctivitis, foreign bodies and 
in the second stage of distemper and moon eye. The discharge 
from the eye would be bloody in an injury to the lid. A chronic 
thickening of the eyelids would indicate eczema, phlegmon, 
necrosis, new formation or furunculosis. 

Conjunctiva. 

The inspection of the conjunctiva is usually done by turn- 
ing the lid inside out, and passing the finger around the con- 
junctival sack. An abnormal redness indicates acute con- 
junctivitis. If the vessels of the conjunctiva are congested, this 
is diagnostic of acute keratitis, cyklitis or panopthalmia. A 
paleness or yellowness indicates a catarrhal or a chronic sup- 
purative conjunctivitis. In parenchymatous and phlegmonous 
conjunctivitis there is an extreme thickening and swelling of 
the conjunctiva. An enlargement or thickening of the lymph 
follicles assuming the form of granulation tissue is character- 
istic or follicular conjunctivitis. 

The membrane nictitans is examined either by passing 
the finger around it, or pulling it out with a pincette. 

The lachrymal sack and lachrymal duct may be examined 
by probing. 



236 The Practice of Veterinary Surgery 

Bulb. 

An atrophy or a shrinking of the bulb is diagnosed by the 
fact that the bulb becomes soft in consistency and the eyelids 
become wrinkled and this condition can only be diagnosed 
positively by comparison. This indicates moon blindness or a 
congenital microphthalmus (one eye smaller than the other). 
An enlargement of the bulb would indicate retro-bulbary 
phlegmon, exopthalmus (protusion of the eyeballs), hydrop- 
thalmus, new formations, strabismus (squint), nystagmus 
(continual movement of one eye). 

Cornea. 

Any inflammatory condition of the cornea causes it to 
become opaque. A roughness, a bluish discoloration, grayish 
or whitish discoloration, or the color of smoke indicates the 
presence of parenchymatous keratitis. If any of these condi- 
tions should become chronic it would indicate the presence of 
a leucoma. A yellowish discoloration indicates the presence 
of a suppurative keratitis. A brownish or black spot on the 
cornea indicates that there has been an ulcer there and this is 
the cicatrix. 

Infections of the cornea may be superficial or deep. Nor- 
mally the cornea is smooth and reflects somewhat like a mirror, 
ins'tead of this superficial inflammation of the cornea, it be- 
comes rough and uneven, opaque and in some cases milky. In 
deeper affections of the cornea it is usually swollen and sym- 
metrical in shape. 

Anterior Chamber of the Eye. 

In cases of iritis the anterior chamber contains flakes of 
fibrin. This usually indicates the presence of periodical 
opthalma. It may contain greenish pus ; this would indicate 
suppuration. In iritis and suppurative cyklitis it may contain 



The Practice of Veterinary Surgery 237 

a bloody or a fibro hemorrhagic exudate. This would also 
indicate the presence of periodical ophthalmia. A shrinking or 
an atrophy of the anterior chamber indicates the presence of 
chronic periodical opthalmia or anterior synechia. An enlarge- 
ment of the anterior chamber of the eye ind'icates the presence 
of luxation of the lens or the formation of posterior synechia, 
or hydrophthalmus. 

The Iris and the Pupil. 

The color, movement and general structure must be con- 
sidered. The color is black except in animals that have no 
pigment in the eye. A reddish or greyish discoloration of the 
iris indicates the presence of iritis. In iritis the iris is also 
swollen and covered with a fibrous exudate. A visible vascu- 
larization indicates the presence of acute iritis or periodical 
opthalmia. In chronic iritis the iris becomes flabby and 
shrunken. 

If the iris becomes adherent to the lens it indicates pos- 
terior synechia, this is usually seen to accompany periodical 
ophthalmia. 

In the examination of the pupil, the size and the evenness 
of the edges are to be taken into consideration. If the edge 
becomes very ragged it is an indication of periodical opthalmia. 
The pupil becomes narrow as the result of any painful affec- 
tion of the eye. Also in an acute and chronic iritis chronic 
narrowing of the pupil is seen. Retinitis, meningitis and vari- 
ous drugs may have this same effect. 

An abnormal dilation of the pupil which becomes chronic, 
indicates a paralysis of the retina and optic nerve. A paralysis 
of the retina is also seen in diseases of the brain, in a paralysis 
of the outer motor apparatus of the eye, in various poisonings, 
and in certain infectious and contagious diseases. There are 
certain medicinal agents that also affect the eye causing this 
same condition. The pupil becomes immovable and does not 



238 The Practice of Veterinary Surgery 

respond to light in certain nervous conditions such as iritis, 
cyklitis and moon eye. 

Posterior Chamber of the Eye. 

By the posterior chamber of the eye is meant the space 
between the retina, the lens, ciliary bodies and iris. 

To discover the presence of iritis and cyklitis, the examina- 
tion of the posterior chamber of the eye is very advantageous. 

In chronic cyklitis there is a form of posterior synechia 
which indicates the presence of moon blindness. The exam- 
ination of the posterior chamber of the eye is impossible with- 
out the use of atropine. 

Lens. 

The lens is examined for opacity and abnormal positions. 

To examine the lens properly it is necessary to use the 
head mirror and light. 

Chronic opacity of the lens may be any color or shape and 
indicates the presence of a cataract. 

A luxation or subluxation of the lens may take place in 
either the posterior or anterior chamber of the eye. 

Retina. 

The retina is examined by the use of the head mirror only. 
The retina may become opaque, cloudy and pale as a result of 
paralysis or malnutrition. 

A loosening of the retina indicates a paralysis of the nerve, 
the presence of retinitis or an atrophic condition of the papilla. 

An atrophic condition of the papilla is diagnosed by the 
fact that the papilla becomes small, greenish, pale and has the 
appearance of being cut ofiE square. 

In amaurosis the ciliary bodies become opaque and almost 
invisible. 



The Practice of Veterinary Surgery 239 

Examination of the Pupil and Lens with the Mirror. 

Small opacities in the lens are recognized as dark or 
immovable spots. The darker and larger the cataract the 
darker and denser it will appear by condensing light upon it. 
If the entire lens is opaque it is impossible for light to pass 
to the posterior part of the eye. Small circumscribed opacities 
on the posterior surface of the lens have the appearance of a 
cloud or shadow. 

From a forensic standpoint it is quite necessary that the 
-Spot or cataract be located definitely. 

If atropine is injected into the eye the entire lens may be 
readily examined. 

A complete opacity will act as a mirror and reflect light. 
An opacity of the lens must be differentiated from a floating 
body in the posterior chamber of the eye. 

Palpation of the Eyeball. 

The eyeball is palpated to locate a rise in temperature and 
to ascertain its consistency. The consistency would either be 
more firm or softer than normal. If the consistency is softer 
it indicates an atrophic condition of the bulb. If the con- 
sistency is more firm than normal it would indicate hydroph- 
thalmia. 

The most common diagnostic agents are a four per cent 
solution of cocaine to allay the pain followed by five drops of 
a five per cent solution of atropine. 

EXAMINATION OF THE SINUSES AND 
NASAL CAVITY. 

Inspection. 



First examine the nasal discharge, to determine whether 
unilateral or bilateral, 
sistency, color and quantity. 



it is unilateral or bilateral. Then the discharge itself for con- 



240 The Practice of Veterinary Surgery 

If the consistency of the nasal discharge is catarrhal or 
muco-purulent it indicates the presence of a catarrhal or sup- 
purative inflammation in the nasal cavities or sinuses, frac- 
ture or new formations. 

If this discharge is discharged in varying quantities it is 
indicative of empyema of the sinuses or gutteral pouches. 

A nasal discharge that is mixed with blood would indi- 
cate the presence of adeno-fibroma, adeno-hyperplasia, 
angioma, glanders or fracture. The odor of the discharge is 
quite diagnostic. A sort of a sweetish, fetid odor indicates 
the presence of necrosis. A very offensive odor indicates 
caries of the teeth. 

A swelling in the region of the false nostril would be 
caused by phlegmon, malignant oedema, petechial fever and 
glanders, 

A swelling in the region of the nasal, frontal or maxillary 
bones would indicate the presence of phlegmon, fracture, 
periostitis, empyema of the sinuses or new formations in the 
sinuses. 

There is another form of swelling which appears in this 
region and that is a congenital malformation due to rhachitis, 
or osteo malacia. This generally appears in young animals 
and is most commonly bilateral and must be distinguished 
from empyema. Fistula in this region may indicate that the 
animal has been trephined and has not healed, or the presence 
of a compound fracture. 

Examination of the nasal mucous membrane should be 
made for color, consistency, as to ulceration, erosion or polypi 
on its surface. 

The upper part of the nasal cavity is hard to examine in 
the horse, and can only be made by reflection or probing with 
a horse catheter. With a catheter, tumefaction, painful swell- 
ings, abscesses and hydrops can usually be located. 

Ascertain whether the skin is movable or not over the 
external swelling. If the skin is immovable it indicates the 



The Practice of Veterinary Surgery 241 

presence of phlegmon or fistula. If the skin is abnormally 
loose it indicates an impression. 

The most common form of tumefaction which appears in 
the nasal cavity is polypus. A polypus must be dififerentiatecl 
from a foreign body. A thickening of the upper part of the 
nasal cavity indicates a tumor of some kind. A thickening in 
the lower third of the nasal cavity indicates a hyperplastic 
inflammation of the mucous membrane. 

The exhaled air should be examined first for temperature 
and then for absence. The absence of exhaled air from one 
nostril indicates the presence of stenosis, or a stenotic condi- 
tion of some kind. 

It is also necessary to examine the submaxillary lymph 
gland to make a diagnosis. The hmiph glands are examined 
as to size, consistency, movability, whether they are painless, 
painful, or adherent to the connective tissue surrounding 
them. If the lymph glands are enlarged and painless on one 
side it indicates the presence of sarcoma or carcinoma. Em- 
pyema is diagnosed by the lymph glands being painful and 
swollen on the affected side. 

Percussion — Percussion of the sinuses is used to locate a 
new formation, empyema, or hydrops of the sinuses. If on 
percussion there is a peculiar resonant sound it indicates the 
presence of empyema or hydrops. This must not be confused 
with a thickening" of the bone as a result of rachitis, 

Ausculation — Ausculation is of advantage only to locate 
stenosis. 

Examination of the Mouth Cavity. 

For examination of the mouth cavity a speculum must be 
used. 

First inspect the lips and cheeks, examine for wounds, 
eczeina, phlegmon, new formations and paralysis. 

Also inspect the saliva as to whether or not it contains 
pus. If it contains pus it indicates the presence of wound's, 



242 The Practice of Veterinary Surgery 

ulceration of the mucous membrane, necrosis of the mucous 
membrane of the mouth, tongue or pharynx. A foul smelling 
discharge from the buccal cavity usually indicates a foreign 
body or caries. 

The teeth should be examined for a number of things. 
The bite; this may be shear mouth or step mouth, there may 
be teeth absent, there may be long or short teeth, there may 
be caries, necrotic teeth or alveolar periostitis. 

The lower jaw should be examined for bit pressure, 
necrosis, deformity, exostosis and fistula. 

If the animal eats slowly and carefully it usually indicates 
a lesion in the mouth cavity. Excessive salivation usually 
indicates diseases of the teeth, stomatitis, glossitis or foreign 
bodies. 

Examination of the Neck. 

Examination of the neck is done mainly by palpation and 
inspection. 

The neck is examined for wounds, fistula, glanders, 
abscesses, poll evil, phlegmon, goiter, or an abnormal condi- 
tion. 

By means of palpation the temperature and painfulness 
of the swelling may be ascertained. 

Puncture may be resorted to in cases of swellings that 
are hard to diagnose. 

The most common condition found in the region of the 
parotid gland is a firm hard swelling. This indicates the 
presence of a sub-parotid abscess or an abscess in the guttural 
pouch. Empyema of the guttural pouch is diagnosed by a 
doughy, fluctuating painless tumefaction in the region of the 
parotid. 

Examination of the larynx is carried out mainly by pal- 
pation and exploration. 

Palpation of the larynx would reveal the presence of 
oedema, partial paralysis, inflammation or the formation of a 



The Practice of Veterinary Surgery 243 

tumor. Palpation of the larynx will usually locate a unilateral 
or a partial paralysis as is seen in roaring. 

The trachea is examined for stenosis, ossification of frac- 
ture. 

The oesophagus is examined for stenosis, diverticulum, 
rupture, difficult deglutition, or for regurgitation of food. 
The exact diagnosis can only be made by the use of a probe or 
probang. 

Examination of the Thorax. 

The breast is examined for wounds, fistula, phlegmon 
and new formations. 

By palpating a new formation the presence of an abscess 
can be located. 

A sternal fistula should always be probed to locate its 
direction and size. 

The foreflank should be examined for accidental per- 
forating wounds, superficial wounds, circumscribed and diffuse 
swellings. A diffuse swelling usually indicates the presence 
of a phlegmon or fractured rib. Also examine the foreflank 
for fistula and new formations. 

By palpating the consistency can be determined. 

An abscess is a circumscribed accumulation of pus within 
the tissue and presents the following symptoms : A cir- 
cumscribed swelling which is hot and painful. The skin is 
tense and immovable, very hard at the periphery and softer 
in the center. 

A hematoma is a hemorrhage into the connective tissue 
and may be diffuse or circumscribed. It presents the follow- 
ing symptoms : It is cold, painless and fluctuates over its 
entire area and the skin is movable over all its parts and it 
may' terminate by encapsulation, while an abscess generally 
points but may encapsulate. 

A suppurative phlegmon is a diffuse suppurative inflam- 
mation of the connective tissue, which gives rise to a diffuse 



244 The Practice of Veterinary Surgery 

firm swelling, which is the same consistency over its entire 
surface. This usually lead's to a fistula and suppuration. 

The witness should be examined for fistulae. Fistulae 
in the region of the withers must be differentiated from hemo- 
toma, subcutaneous abscesses and pressure necrosis from the 
harness. A diffuse suppurative phlegmon in the region of the 
withers usually has an unfavorable prognosis. 

Special Examination for Lameness. 

Lameness is any disturbance of normal motion. 

In a general way lameness is due to three things. First, 
painful inflammatory conditions ; second', any mechanical 
hindrance to motion, and third, a paralysis of the nerve or 
muscle. Painful inflammatory conditions includes arthritis, 
distortion, contusion, luxation, myositis, muscle rupture, ten- 
donitis, tendovaginitis, bursitis, fracture, periostitis, ostitis, 
neuritis, neuroma, pododermatitis, dermatitis, phlegmon, etc. 
Mechanical hindrance to motion includes contraction, exosto- 
sis, ankylosis, stiltfoot, ringbone and spavin. The most com- 
mon forms of paralysis, are paralysis of the prescapular, of 
the radical, of the crural and of the obturator nerves. The 
most common forms of muscular paralysis are paralysis of the 
arytenoids and paralysis of the quadriceps femoris. 

Examine the animal to see if the lameness has appeared 
suddenly. Has the lameness appeared while the animal was 
in motion? Does the lameness interfere with motion? If so, 
is it a swinging leg lameness. 

If the lameness interferes with supporting the weight it 
is supporting leg lameness. 

If it interferes with flexion and extension it is called 
swinging leg lameness. 

The lameness usually is classified with the part affected. 
If the lameness is above the carpus and tarsus it usually gives 



The Practice of Veterinary Surgery 245 

rise to a swinging leg lameness. If below it gives rise to a 
supporting leg lameness. 

According to the severity of the lesion there are three 
grades of lameness. 

The most severe is known as a high grade lameness and 
indicates that the animal cannot place the leg on the ground. 

A second or middle grade lameness indicates that the 
animal is able to place the toe of the affected part on the 
ground and support some weight. This is usually seen in 
distortion, podotrochlitis and nail puncture. 

The third grade indicates that the animal is able to place 
the foot squarely on the ground but can only support the 
weight of the part for a short time. 

Swinging leg lameness indicates either an impossibility 
or slowness of extension and flexion of the leg, or the step is 
very short and choppy. In swinging leg lameness nodding of 
the head is not very pronounced but becomes more severe in 
sand or on soft roads. Swinging leg lameness indicates that 
the lesion is either in the shoulder or the croup. 

Supporting leg lameness is the most common form. 

In supporting leg lameness the leg can be extended or 
flexed, normally, but the animal is unable to bear the weight of 
the body on it. Supporting leg lameness indicates a lesion 
in the foot, or one of the joints below the carpus, the tendon, 
or a fracture. In supporting leg lameness the step is very 
short and rapid. 

A very suddenly appearing lameness is usually due to 
distortion, rupture of a muscle or a tendon, fracture or luxa- 
tion. 

Diagnostic Cocaine Injection — In doubtful cases and in 
cases where the lameness cannot be definitely located subcuta- 
neous cocaine injections should be resorted to. 

The injections should be made immediately over the course 
of the nerve. The cocaine injection should be made over the 
digital nerve first, then if the lameness subsides it indicates 



246 The Practice of Veterinary Surgery 

the presence of the lesion below that part. The next injection 
should be made over the plantar ; if the lameness subsides it 
shows that the lesion is at that point or below it. If the 
iameness does not cease the next injection should then be 
made over the median nerve. If the lameness ceases this indi- 
cates that the ksion is below that point. If the lameness still 
exists after making these injections, an injection should be 
made over the ulnar nerve. If the lameness subsides, the 
lesion is in the region of the carpus or flexor tendbns. 

Cocaine injections of the hind leg should be somewhat 
similar. The posterior tibial should be anaesthetized to locate 
lameness for ringbone, and the anterior tibial and posterior 
tibial should be anaesthetized for a spavin lameness. 

To relieve the sensation around the face anaesthetize the 
trifacial nerve. A diagnostic cocaine injection should be 
made before neurectomy is performed. If the lameness is 
relieved the animal will make a good recover)^ following the 
operation. A very satisfactory solution for making these 
injections may be made as follows: Add ten grains each of 
cocaine and boric acid to an ounce of water, dissolve and use 
fifteen drops at each injection. 

SPECIAL EXAMINATION OF THE SHOULDER. 

Shoulder Lameness. 

This particular kind of lameness is swinging leg lame- 
ness and generally indicates the presence of a diseased condi- 
tion of the muscle, paralysis, a disease of rheumatic origin, 
an abscess or a new formation. 

Atrophy of the shoulder muscles is not an indication of 
shoulder lameness except in very young animals when it may 
occur. 

The shoulder should be examined for excessive heat, cir- 
cumscribed painful areas or contusions. The consistency of 
these new formations would indicate their structure. 



The Practice of Veterinary Surgery 247 

Abnormal motion in the part indicates a fracture. 

If a rotating movement of the shoulder causes pain the 
lesion may be in the region of the shoulder joint. 

Before diagnosing shoulder lameness a cocaine injection 
over the median nerve should be resorted to, to be sure it is 
not below that point. 

Examination of the Carpus. 

The lameness which is shown by a lesion in the carpus 
is usually supporting leg lameness, but may be mixed lame- 
ness. 

The carpus must be examined for swellings, these may 
be circumscribed or diffuse, or the lesion may involve the 
joint itself. Lesions involving the joint usually appear on the 
mner surface. A lesion or swelling entirely around the joint 
generally indicates the presence of chronic deforming arthritis 
or hydrops of the joint. A change of position or abnormal 
movement of the joint is very rare ; if present it would indicate 
luxation or fracture. 

The flow of synovia from a wound surrounding a joint 
indicates a puncture of a tendon sheath or the joint capsule. 

By palpating the new formation in the region of the joint 
its consistency or origin can usually be determined. 

Examination of the Flexor Tendons. 

The most common diseases which affect the flexor tendons 
are tendonitis and tendo-vaginitis. The lameness appears 
suddenly and is supporting leg lameness. 

There may be a contraction of one of the tendons which 
can be readily felt and gives rise to the formation of stiltfoot. 
If the heel strikes the ground first and the toe is somewhat 
elevated, it indicates the presence of a rupture of the perforans 
tendon. 



248 The Practice of Veterinary Surgery 

Swellings in the region of the tendon are usually diffuse 
but may be circumscribed. Circumscribed swellings indicate 
hydrops calluses, or tendovaginitis. These swellings should 
be palpated to determine a rise in temperature, painfulness 
and consistency. A difference must be made between ten- 
donitis and tendovaginitis. 

By palpation a rupture can usually be located. 

Examination of the Hoof. 

Examination of the hoof is carried on by means of inspec- 
tion, palpation, percussion, mensuration and by the examina- 
tion of the digital pulse. 

First see if the position of the foot is normal or abnormal. 
The reason for examining the position of the foot is the fact 
that the position will cause a faulty formation of the hoof. 

The hoof should be examined for atrophy, this being very 
important from a legal standpoint. 

The shoe should be examined; if the shoe is worn off too 
much in front it indicates the presence of spavin, chronic 
deforming gonitis or stiltfoot. 

A pathological ring on the hoof is very thick and abrupt 
and usually diverges from the toe to the heel. Physiologically 
normal rings are of the same consistency around the foot and 
are usually due to a sudden change in the surrounding co^n- 
ditions. A partial ring formation is abnormal and generally 
indicates the presence of pododermatitis. 

Examination of the Sole. 

Examine the sole of the foot to see if it is arched or flat, 
and if the white line is normal. A flat sole is generally the 
result of laminitis or pododermatitis. The sole should be 
examined for corns. Corns are contusions. 



The Practice of Veterinary Surgery 24.9 

Examination of the Frog. 

A severe swelling or beat in the frog indicates the pres- 
ence of a lesion in the fatty frog. 

An atrophic condition of the frog indicates the presence 
of some chronic disease and is usually accompanied by an 
atrophic condition of the entire foot. 

Examination of the Coronary Band. 

This should be examined for swelling, infectious pro- 
cesses and subcoronary phlegmon. 

A sinking of the coronary band accompanies a sinking 
of the OS pedis, with a flattening of the sole. 

Fistulae, quittor, or keloids must be differentiated from 
warts in the region of the foot. 

Keloids consist of an abnormal cicatrix which has become 
horny. As a rule this is due to an infection which affects the 
bulb or the heel. 

A quittor may appear in the heel. 

Palpation of the Hoof. 

The hoof is palpated by means of hoof tongs. These 
should be used to locate sensitiveness within the horny wall. 
In using a hoof tong one foot must be compared with the 
other because a good many horses with sound feet will flinch. 

Acute infectious processes involving the foot are usually 
accompanied by heat. 

Chronic lameness and fractures are generally cold. 

Palpation of the foot may also be done by the thumb. 
By bringing undue pressure upon the bulb the animal may 
show pain which indicates the presence of navicular disease. 

By passive movement, the leg being flexed, rotated, etc., 
arthritis, periarthritis and articular ringbone may be diagnosed, 

17 



250 The Practice of Veterinary Surgery 

also a side bone, that is if the new formation will give rise to 
pain by pressure or flexion, in this region. 

Percussion of the Hoof. 

The hoof is percussed with a hammer. Usually a black- 
smith's hammer is used. Tapping must be gentle because a 
hard blow on a normal foot will cause pain. 

By percussion a separation of the wall, or a chronic podo- 
dermatitis ma)?- be diagnosed. 

Mensuration. 

Measuring the foot is of great importance from a legal 
standpoint. This should be done with a wire or steel tape line. 

The measuring should be done at the coronary band on 
the hoof, half way from the coronary band and sole, and on 
ground surface. 

However mensuration cannot be relied upon unless the 
feet have been properly taken care of and properly pared. 

The angle of the foot should be measured. The reason 
being to determine if the lesion is causing a mechanical faulty 
position of the limb. 

Examination of the Urinary Tract. 

Examination of the urinary tract is carried on by rectal 
examination of the bladder, urethra and examination of the 
urine itself. 

The examination of the bladder per rectum would indi- 
cate painfulness, thickening or a distention. 

The examination of the urethra is mainly for a stenosis or 
some foreign body. 

The manner in which urine is voided normally is in a 
continuous stream. 



The Practice of Veterinary Surgery 251 

There may also be a retention of the urine. This may be 
due to the urethra containing a foreign body, or there may 
be an accumulation of smegma at opening of urethra. It may 
also be due to new formations, strictures, paralysis of the 
bladder, or urethra. 

The urine may be voided in drops, and if so it is nearly 
always due to a foreign body in the urethra. 

An animal that voids urine without protruding the penis 
usually suffers from partial paralysis of the penis, stenosis or 
a foreign body in the urethra. 

If the urine is of a light brown color it contains blood, if 
dark brown it indicates a hemorrhage of kidney; if light 
colored or fresh blood it indicates the hemorrhage has been 
in the bladder or urethra. 

If the urine contains pus, it indicates the presence of 
ulcers in the bladder. 

The urine rnay contain mucous, which indicates the pres- 
ence of catarrh of the bladder. 

If the urine is extremely foul smelling, it may indicate a 
new formation in the bladder. 

Examination of the Croup or Hind Quarter. 

The croup or hind quarter is examined for atrophy or an 
asymmetrical condition. 

An atrophy of certain parts of the hip is very diagnostic. 
An atrophy of the muscles of adduction and abduction is very 
diagnostic of spavin lameness. A serious atrophy in the 
gluteal region is very diagnostic of gonitis. An atrophic con- 
dition of the quadriceps femoris is diagnostic of a partial 
paralysis. 

"The outward examination of the hip consists of palpation 
to determine fluctuating areas, crepitation and abnormal 
movements. Increased sensibility, consistency and passive 



252 The Practice of Veterinary Surgery 

movement of the hip are produced by rotating the limb, by 
flexion, extension, abduction and adduction. 

Mensuration of the hip to determine the exact atrophic 
condition is of value only from a legal standpoint. 

Rectal Examination. 

Rectal examination is done for a great many different 
purposes. To locate an abnormality of the spleen ; to locate 
the testicle in cryptochidy ; to locate inguinal or scrotal hernia ; 
to examine the uterus for pregnancy or an abnormal condition ; 
to examine the arteries passing through the pelvis (throm- 
bosis) ; to examine the lymph glands in that region ; to ex- 
amine the rectum itself. 

Examine the rectum for increased sensitiveness, swell- 
ing of the mucous membrane, foreign bodies, new formation, 
stenosis or diverticulum. 

Examination for Prolapse of the Vagina, 

Examine the contents and inguinal ring per rectum. The 
internal inguinal ring in ridglings is usually covered with a 
layer of peritoneum. In case of flankers the cord may be felt 
passing through the opening. In case of a cryptorchid the 
testicle can usually be located a few inches forward from the 
internal inguinal ring. The testicle feels like a solid, some- 
what egg-shaped circumscribed fluctuating body. The con- 
sistency is about that of a bag of mercury. In case of a hernia 
the loop of bowel may be felt passing through the ring. 

Examination of the Hock Joint. 

The hock should be examined for abnormal position, new 
formations, malformation, hydrops, acute and chronic inflam- 
matory processes, exostosis, suppurative phlegmon, chronic 



The Practice of Veterinary Surgery 253 

deforming arthritis, for the consistency of any new formation 
as well as for abnormal movement. 

From a legal standpoint it is always well to measure the 
hock. 

Hydrops of the joint itself must not be confused with 
hydrops of the tendons sheaths. Hydrops of the joint is 
usually designated as "bog spavin" or "thoropin." Hydrops 
of a tendon sheath consists of a long, painless, fluctuating 
swelling. 

The joint itself should be examined for congenital mal- 
formation which must not be confused with other lesions. 

PRESCRIPTIONS. 

For a resorbing agent in capped hock, thoropin, bog 
spavin, splints and bursal enlargements. 
Recipe. 

Iodine crystals 1 oz. 

Ether 2 oz. 

Alcohol 2 oz. 

Flexible collodion 2 oz. 

M. f. s. 
Apply once daily for ten days with a brush, then grease 
and in ten days repeat. Repeat as often as necessary to get 
results. 

For a blistering agent in splints, spavins and ring bones 
which are forming. 
Recipe. 

Iodine crystals 2 dr. 

Potassium iodine 1 dr. 

Red iodine of mercury 2 dr. 

Alcohol 2 oz. 

M. f. s. 
Apply once daily with brush for three days, then grease 
and do not repeat under two weeks. 



254 '^^^ Practice of Veterinary Surgery 

Escharotic paste for sloughing fistulous tracts as "poll 
evil," "quittor," "fistula of the withers," etc. 

Recipe. 

Zinc chloride 4 oz. 

Water 1 oz. 

Gum Arabic 1 oz. 

Powdered blood root 4 oz. 

Mix in order given and roll out into sticks and pack canal. 
If possible suture wound to keep packing in place. After seven 
days remove the slough and treat wound as an open wound. 



Ointment for ring worm, eczema and skin diseases in 
dogs. 

Recipe. 

Calomel 1 dr. 

Salicylic acid 20 grs. 

Resorcin 20 grs. 

Zinc oxide 1 dr. 

Starch 2 drs. 

Lanolin Yz oz. 

Benzoated lard ^ oz. 

M. f. ointment. 
Apply twice or three times daily to affected parts. 



White liniment for general use. 

Recipe. 

One quart soft water. 
Six eggs. 

Acetic acid 8 oz. 

Turpentine 16 oz. 

Beat eggs thoroughly and add water. Shake well and add 
acetic acid slowly. Shake well again and add turpentine. 
Shake well daily for ten minutes for a week. Dilute for use. 



The Practice of Veterinary Surgery 355 

Liquid blister for a general blistering agent. 
Recipe. 

Powdered euphorbia 2 oz. 

Powdered cantharides 2 oz. 

Oil of turpentine 8 oz. 

Linseed oil 4 oz. 

Mix and allow to stand ten days before using. Apply once 
daily for three days, for a severe blister. 

For wounds, chaps, scratches, calks and harness galls. 
Recipe. 

Tincture of arnica 2 oz. 

Goulard's extract 2 oz. 

Water 2 pints. 

Apply two or three times daily ; if possible apply cotton 
and a bandage to the part. 

Escharotic paste for sloughing actinomycomas, etc. 
Recipe. 

Zinc chloride 6 oz. 

Water ^ oz. 

Gum Arabic 1 oz. 

Arsenic 2 oz. 

Flour enough for consistency. 
Mix in order given and pack into the openings, allowing 
sloughing to take place. 

To remove the hair for operations. 
Recipe. 

Barium sulphate 3 oz. 

Zinc sulphate 1 oz. 

Starch 1 oz. 

• Add enough water to form a paste. Apply to the part, 
rub in well and allow to dry. After drying rub briskly and 
hair will come out. 



256 The Practice of Veterinary Surgery 

Healing ointment for general use. 
Recipe. 

Creolin 1 dr. 

Oleate of mercury ^ oz. 

Zinc oxide y^, oz. 

Salicylic acid.... 1 dr. 

Vaseline 1^ oz. 

M. f. ointment. 
Apply two or three times daily to wound surface. 



Liniment for general use. 
Recipe. 

Tincture of iodine 1 oz. 

Chloroform 1 oz. 

Tincture of belladonna 1 oz. 

Tincture of camphor 2 oz. 

Alcohol 4 oz. 

Water 8 oz. 

M. f. liniment. 



For spavins, ring bones, splints, etc., which are just form- 
ing or which have not responded to firing. 
Recipe. 

Hydrochloric acid 4 drs. 

Bichloride of mercury 4 drs. 

Alcohol 4 oz. 

Camphor gum 2 oz. 

Oil of turpentine 1 oz. 

Alcohol 18 oz. 

Mix separately, then mix the two parts. 

Apply just enough to thoroughly moisten, then massage 
freely. Do not blister and if a blister is gotten grease and 
discontinue using it until blister has disappeared. 



The Practice of Veterinary Surgery 257 

To keep flies away from a wound or a part of the body. 
Recipe. 

Fish oil -- 1 gal. 

Oil of tar - 1 pt. 

Kerosene /^ gal. 

Crude carbolic acid... 2 pints. 

M. f. s. 
Apply to the parts with a spray pump. 

Blistering ointment that will not leave a scar. 
Recipe. 

Powdered euphorbia 1 oz. 

Powdered cantharides.... 1 oz. 

Vaseline 4 oz. 

Mix in a water bath. Apply once daily for three days 
then grease. 

Liniment for general use. 
Recipe. 

Tincture capsicum 4 oz. 

Tincture myrrh 2 oz. 

Alcohol 2 pints. 

M. f. liniment. 

Gall ointment for all classes of open wounds. 
Recipe. 

Vaseline ' lbs. 

Paraffin 8 oz. 

Oil of turpentine 8 oz. 

Venice turpentine 6 oz. 

Formalin 2>^ oz. 

Verdegris 1 ^'^• 

Mix and allow to stand in a water bath until thoroughly 

mixed. 



258 The Practice of Veterinary Surgery 

Liniment for general use. 

Recipe. 

Sulphuric acid 4 oz. 

Potassium nitrate 4 oz. 

Ammonium chloride 4 oz. 

Oil origanum 4 oz. 

Vinegar 4 pints. 

Mix the constituents except the sulphuric acid, then add 
this gradually. 

For scratches. 

Recipe. 

Chromic acid 1 oz. 

Water 8 oz. 

M. f. solution. 
Apply twice daily. 

Blistering Balsam. 

Recipe. 

Powdered cantharides 2 oz. 

Powdered euphorbia 1 oz. 

Alcohol (denatured) 1 pint 

Mix, allow to stand for ten days, then filter. Apply with 
a brush. 



Sweating Blister. 

Recipe. 

Oil of spike 1 oz. 

Oil of hemlock 1 oz. 

Tincture cantharides 2 oz. 

Alcohol 8 oz. 

Mix, bathe the parts with warm water, then apply blister 
and bandage loosely. 



The Practice of Veterinary Surgery 259 

Gall ointment for harness galls and collar bruises. 
Recipe. 

Zinc oxide 1 lb. 

Calcium oxide 1 lb. 

Venice turpentine 2 oz. 

Vaseline 2 lb. 

Mix in a water bath. 



Dusting powder to be used on wound surfaces. 
Recipe. 

Powdered zinc oxide 8 oz. 

Slacked lime 8 oz. 

Powdered alum 4 oz. 

Mix thoroughly and apply through a sprinkle top can. 



Dusting powder. 
Recipe. 

Tannin. 

Powdered alum. 

Boric acid equal parts. 

Mix thoroughly and apply as above. 



Dusting powder. 
Recipe. 

Powdered willow charcoal 8 oz. 

Zinc oxide 8 oz. 

Naphthaline 8 oz. 

Mix thoroughly and apply as above. 



Dusting powder. 
Recipe. 

Iodoform 1 oz. 

Tannin 4 oz. 

Powdered sugar 4 oz. 

Mix thoroughly and apply as above. 



26o The Practice of Veterinary Surgery 

Wound Varnish. 

Recipe. 

Bichloride of mercury, 1 to 1000 solution. 
Gelatin, as much as the above will dissolve. 

When the gelatin is dissolved add ten per cent glycerine. 



Wound Varnish. 

Recipe. 

Zinc oxide 50 parts. 

Water 50 parts. 

Zinc chloride 5 parts. 

Mix. 



A SIMPLE METHOD FOR MAKING AUTOGENIC 

BACTERINS. 

Take one-half ounce of pus from the wound, add to this 
five ounces of normal saline solution. Place in a bottle, then 
in a double boiler and incubate for three to four hours at a 
temperature of 140 degrees F. Next filter or strain through a 
clean cloth, then add five drops of phenol to each ounce. The 
first injection should be 5 cc, if this dose is too great a reaction 
will be shown by an increase in the discharge from the wound. 
If the reaction occurs inject 3 cc. in five days and inject a 
sufficient amount every five days to reach the point of reaction. 



MAV 8 1912 



